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Contents 

PAGE 

Map 2 

Medical  Inspection  Legislation  in  America 5 

Principal  Features  of  Laws 6 

Abstract  of  Laws  and  Regulations 7 

Provisions  New  Laws  Should  Include 11 

California 12 

Colorado 14 

Connecticut ,....15 

— District  of  Columbia 17 

Indiana 28 

Louisiana 30 

Maine 33 

Massachusetts 35 

'  Minnesota 40 

~  New  Jersey 42 

New  York 43 

North  Dakota 44 

Ohio 44 

■  Pennsylvania 45 

-^  Utah 48 

Vermont 49 

Virginia 49 

Washington 50 

-    -  West  Virginia 50 


3 


Medical   Inspection   Legislation  in 
America 

The  first  state  law  providing  for  the  medical  inspection  of  school 
children  appears  to  have  been  passed  by  Connecticut  in  1899. 
It  did  not  provide  for  the  complete  sort  of  inspection  now  carried 
on  in  many  cities  and  states,  but  only  for  the  testing  of  eyesight 
by  teachers  ev^ery  three  years.  Complete  medical  inspection 
with  examinations  for  the  detection  of  physical  defects  was  first 
provided  for  by  state  enactment  in  the  permissive  law  of  New 
Jersey  passed  in  1903.  This  was  followed  by  the  mandatory 
law  of  Massachusetts  in  1906,  which  has  been  several  times 
amended,  and  which  has  served  as  the  basis  for  a  majority  of  the 
bills  which  have  since  been  presented  in  other  state  legislatures. 

At  the  present  time  (May,  191 1),  six  states  have  mandatory 
laws,  ten  have  permissive  ones,  and  in  two  states  and  the  District 
of  Columbia  medical  inspection  is  carried  on  under  regulations 
promulgated  by  the  boards  of  health  and  having  the  force  of 
law.  The  fact  that  the  Massachusetts  statute  is  the  oldest  of 
the  laws  now  in  force  shows  that  the  whole  body  of  legislative 
enactments  which  crystallize  the  views,  beliefs  and  results  of 
experience  of  educators  and  physicians,  is  of  distinctly  recent 
origin. 

Nevertlieless,  the  past  five  years  have  furnished  a  large  body 
of  experience  under  varying  conditions  and  in  widely  separated 
localities,  and  the  lessons  of  this  experience  can  be  read  in  the 
substantial  agreement  of  a  majority  of  the  laws  in  several  salient 
features.  This  is  graphically  shown  by  the  tabular  presentation 
of  the  principal  features  of  the  different  laws  and  regulations 
printed  on  page  6. 

On  four  points  there  is  substantial  agreement.  The  first  is 
that  the  administration  of  the  provisions  of  the  laws  is  placed  in 
the  hands  of  the  school  authorities.  The  second,  third  and 
fourth  are  respectively  placing  in  the  hands  of  school  physicians 
the  inspection  for  contagious  diseases,  the  physical  examin- 
ations, and  the  inspection  of  teachers,  janitors  and  buildings. 
In  six  cases  provision  is  made  for  testing  of  vision  and  hearing 
by  the  teachers. 

A  clear  idea  of  the  {principal  provisions  of  the  different  laws 
may  be  gained  by  reading  the  abstract  beginning  on  page  7. 

5 


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Abstract  of  Laws  and  Regulations 

1.  California 

Adopted  1909 — Permissive — Applies  where  adopted 

Administered  by  school  authorities 

Provides  for  health  and  development  supervision  of  teachers 

and  pupils 
Inspectors  may  be  either  physicians  or  educators 

2.  Colorado 

Adopted   1909 — Mandatory — Applies  to  all  public  schools 

Administered  by  school  authorities 

Teachers  or  principals  test  sight,  hearing  and  breathing 
of  all  pupils  annually 

School  authorities  report  to  parents  mental,  moral  or  physical 
defectiveness  discovered 

Enforcement  by  State  Bureau  of  Child  and  Animal  Protec- 
tion 

3.  Connecticut 

Adopted  1907 — Permissive — Applies  where  adopted 
Administered  by  school  authorities 
Physicians  inspect  children  for  contagious  diseases 
Physicians    may    examine    teachers,    janitors    and    school 

premises 
Physicians  conduct  sight,  hearing  and  physical  examinations 

annually 
Defects  reported  to  parents 
School  authorities  may  appoint  school  nurses 

4.  District  of  Columbia 

Regulations  of  Health  Officer  and  Board  of  Education 
Adopted  in  present  form  in  1907 — Mandatory — Applies  to 

all  public  schools 
Administered  by  health  authorities 
Physicians  examine  for  contagious  diseases 
Physicians  examine  sanitary  conditions  of  buildings 
Physicians  may  examine  teachers  and  janitors 

5.  Indiana 

Adopted  191 1 — Permissive — Applies  where  adopted 
Administered  by  school  authorities 

7 


8 

Physicians  inspect  chikiron  f(ir  contagious  diseases 

Teachers  may  test  si.nht  aiul  Iicaring  annually 

Physicians  conduct  physical  examinations 

Defects  re}X)rted  to  parents 

Not  more  than  2000  children  for  one  physician 

Compensation  of  physician  not  less  than  $5  for  each  school 

month 
Physicians  may  examine  teachers,  janitors  and  buildings 
If  parents  are  too  poor  to  provide  necessary  medical  treat- 
ment it  shall  be  paid  for  from  public  funds 
rinalt\-  of  $5  to  ;?50  for  violation  of  provisions  of  act 

6.  Louisiana 

Adopted  191 1 — Regulations  of  Sanitary  Code  of  State 
Board  of  Health  having  force  of  law — Mandatory — 
Applies  to  all  public  schools 

Administered  by  school  authorities 

Principal  of  each  school  makes  monthly  report  on  physical 
condition  of  children  and  sanitary  condition  of  build- 
ings on  blanks  furnished  by  State  Board  of  Health 

Principals  and  teachers  exclude  children  suffering  from 
contagious  disease 

7.  Maine 

Adopted  1909 — Permissive — Applies  to  cities  and  towns  of 

less  than  40,000 
Administered  by  school  authorities 
No  more  than  1000  pupils  to  a  physician 
Physicians  inspect  children  for  contagious  diseases 
Physicians  may  examine  teachers,  janitors  and  buildings 
Tests  of  sight  and  hearing  annually  by  teachers  or  physicians 
Physical  examinations  annually  by  physicians 
Defects  reported  to  parents 

8.  Massachusetts 

Adopted  1906 — amended  1910 — Mandatory — Applies  to  all 

public  schools 
Administered  by  school  or  health  authorities 
Physicians  inspect  children  for  contagious  diseases 
Physicians  may  examine  teachers,  janitors  and  buildings 
Tests  of  sight  and  hearing  made  by  teachers  annually 
Physicians  make  physical  examinations  of  children  annually 
Defects  reported  to  parents 
Normal  schools  train  students  in  testing  sight  and  hearing 


Physicians  conduct  examinations  of  minors  applying  for  age 
and  schooling  certificates 
9.  Minnesota 

Regulations  of  Board  of  Health  having  force  of  law 

Adopted  1910 — Mandatory — Applies  to  all  public  schools 

Administered  by  health  authorities 

Physicians  examine  for  contagious  diseases 

Physicians  may  inspect  teachers,  janitors  and  buildings 

Physicians  conduct  physical  examinations  annually 

Defects  reported  to  parents 

Teachers  test  sight  and  hearing  annually 

Normal  schools  train  pupils  in  testing  sight  and  hearing 
ID.  New  Jersey 

Adopted  1909 — Mandatory — Applies  to  all  public  schools 

Administered  by  school  authorities 

Physicians  examine  for  contagious  diseases 

Physicians  conduct  physical  examinations,  including  sight 
and  hearing  tests 

Defects  reported  to  parents 

Physicians  deliver  hygiene  lectures  to  teachers 

Parents  and  guardians  may  be  proceeded  against  as  dis- 
orderly persons  for  failure  to  remove  any  pathological 
condition  which  may  cause  a  child's  exclusion  from 
school 

11.  New  York 

Adopted  1 9 10 — Permissive 

Authorizes  school  authorities  to  expend  school  funds  for  the 
support  of  medical  inspection 

12.  North  Dakota 

Adopted  191 1 — Permissive — Applies  where  adopted 
Administered  by  school  authorities 
Physicians  conduct  physical  examinations  annually 
Defects  reported  to  parents 

Co-operates  with  Board  of  Health  to  curb  contagious 
disease  and  to  secure  treatment  for  indigent  children 

13.  Ohio 

Adopted  1910 — Permissive — Applies  to  cities 
Administered    by    school  authorities,  but  powers  may  be 

delegated  to  health  authorities 
Physicians  inspect  children  and  vschools 
School  nurses  may  be  employed 


10 

14.  Pennsylvania 

Adopti'd  11)1 1 — Mandatory  in  districts  of  first  and  second 
class — IVrniissivc  in  districts  of  third  and  fourth  class. 
Districts  of  first  class  arc  those  of  more  than  500,000 
iwpulation,  second  class  from  30,000  to  500,000,  third 
class  5,000  to  30,000,  and  fourth  class  less  than  5,000 

Administered  by  school  authorities 

Physicians  conduct  complete  physical  examinations  of 
children  annually 

Plusicians  make  sanitary  inspection  of  school  premises 
annually 

In  districts  of  fourth  class  medical  inspectors  are  appointed 
by  State  Commissioner  of  Health 

Provision  for  employment  of  graduate  nurses 

15.  Utah 

Adopted   191 1 — Mandatory — Applies  to  all  public  schools 

Administered  by  school  authorities 

Teachers  or  physicians  examine  all  children  annually  for 

defect  of  sight  or  hearing,  defective  teeth  or  mouth 

breathing 
Defects  reported  to  parents 

16.  Vermont 

Adopted  1 910 — Permissive — Applies  where  adopted 

Administered  by  school  authorities 

Physicians   inspect   pupils   as   provided   by   rules   of   State 

Board  of  Health 
On  request,  physicians  examine  pupils  of  private  schools 

17.  Virginia 

Adopted  1910 — Permissive — Applies  where  adopted 
Administered  by  school  authorities 

Authorizes  school  boards  to  support  systems  of  medical 
inspection 

18.  Washington 

Adopted  1909 — Permissive — Applies  to  cities  of  first  class 
Administered  by  school  authorities 

Authorizes  school  boards  to  appoint  medical  inspectors  who 
shall  report  monthly  on  health  conditions  in  each  school 

19.  West  Virginia 

Adopted  191 1 — Mandatory  in  cities,  permissive  in  country 

districts 
Administered  by  school  authorities 


II 

Physicians  inspect  children  for  contagious  diseases 
Physicians  conduct  physical  examinations  annually 
Physicians,  on  request  of  board,  report  on  lighting,  ventila- 
tion, etc. 
School  nurses  may  be  employed 


Provisions  New  Laws  Should  Include 

A  comparative  study  of  the  provisions  of  the  different  laws 
shows  that  with  the  added  experience  gained  through  knowledge 
of  how  the  older  measures  have  met  the  test  of  time,  school 
physicians  and  educators  have  incorporated  in  some  of  the  more 
recent  measures  features  which  are  genuine  improvements,  and 
which  should  be  provided  for  in  bills  for  new  medical  inspection 
acts  and  amendments  of  the  old  ones.  The  following  are  the 
features  which  it  would  seem  ought  to  be  included  in  bills  for 
new  medical  inspection  laws: 

1.  A  provision  that  the  administration  of  the  system  of  medical 
inspection  shall  be  in  the  hands  of  the  school  authorities,  but 
that  they  shall  have  the  power  to  delegate  their  authority  to  the 
local  health  officials,  and  that  in  the  treatment  of  cases  of  con- 
tagious diseases  the  school  and  health  authorities  shall  co-operate. 
The  principle  here  involved  is  that  routine  medical  inspection 
and  physical  examinations  arc  primarily  for  insuring  the  health 
and  vitality  of  the  individual  child  and  are  preferably  handled 
by  the  school  authorities  who  are  charged  with  his  daily  care. 
The  curbing  of  epidemics  of  contagious  disease  is  primarily  for 
the  protection  of  the  community,  and  in  this  the  health  authorities 
have  the  right  as  well  as  the  duty  to  intervene.  Examples  of 
such  provisions  as  those  suggested  are  to  be  found  in  the  laws 
of  North  Dakota  and  Ohio. 

2.  Provision  for  inspection  by  school  physicians  to  detect  and 
exclude  cases  of  contagious  disease. 

3.  Provision  for  annual  examinations  of  all  children  by  school 
physicians  to  detect  any  physical  defects  which  may  prevent  the 
children  from  receiving  the  full  benefit  of  their  school  work  or 
which  may  require  that  the  work  be  modified  to  avoid  injury  to 


12 

them.      This    pnn  ision    sluuild    iiuliulo    the    requirement    that 
parents  Ik*  notilietl  of  any  defects  discovered. 

4.  Provision  that  annual  tests  of  vision  and  hearing  shall  be 
conducted  by  the  teachers.  This  i)ri)\isi()n  was  adopted  by 
Massachusetts  on  the  advice  of  the  specialists  in  these  fields  and 
its  wisdom  has  been  demonstrated  by  extensive  experience  in 
that  state. 

5.  Provision  that  the  school  physicians  may  conduct  examina- 
tions of  teachers  and  janitors  and  shall  make  regular  inspections 
of  the  buildings,  premises  and  drinking  water  to  insure  their 
sanitary  condition. 

6.  Provision  that  pupils  in  Normal  Schools  shall  receive  train- 
ing in  conducting  vision  and  hearing  tests.  This  requirement 
is  found  in  the  Massachusetts  law  and  the  Minnesota  regulations. 

7.  Provision  for  the  employment  of  school  nurses.  This  is 
provided  for  in  the  laws  of  Connecticut,  Ohio,  Pennsylvania,  and 
West  \'irs.,Mnia. 

8.  Provision  for  the  enforcement  of  the  law.  Such  provisions, 
not  very  well  developed,  are  found  in  the  laws  of  Colorado, 
Indiana  and  New  Jersey.  The  nature  of  the  provision  must 
vary  with  local  conditions.  In  states  where  municipalities  re- 
ceive a  large  part  of  their  school  funds  from  the  state,  and  their 
school  policies  are  consequently  largely  controlled  through  the 
State  Board  of  Education,  it  seems  clear  that  the  enforcement  of 
the  law  should  be  placed  in  the  hands  of  that  body. 


California 

An   Act   to    Provide   for   Health   and    Development 

Supervision  in  the  Public  Schools  of  the  State 

OF  California 

[Approved  April  15,  1909] 

The  People  of  the  State  of  California,  represented  in  senate  and 
assembly,  do  enact  as  follows: 

HEALTH  AND  DEVELOPMENT  SUPERVISION 
Section  i  .  Boards  of  school  trustees  and  city  boards  of  educa- 
tion are  hereby  authorized  to  establish  health  and  development 
supervision  in  the  public  schools  of  this  state,  and  to  employ 


13 

an  examining  staff  and  other  employees  necessary  to  carry  on 
said  work  and  to  fix  the  compensation  for  the  same.  Whenever 
practicable  the  examining  staff  for  health  and  development 
supervision  in  the  public  schools  of  the  state  shall  consist  of  both 
educators  and  physicians. 

Sec.  2.  The  purposes  of  health  and  development  supervision 
in  the  public  schools  of  the  state  are  hereby  defined  as  follows: 

1.  To  secure  the  correction  of  developmental  and  acquired 
defects  of  both  pupils  and  teachers  which  interfere  with  health, 
growth  and  efficiency,  by  complete  physical  examination.  Said 
examinations  shall  occur  annually  or  as  often  as  may  be  deter- 
mined by  the  board  of  school  trustees  or  city  board  of  education. 

2.  To  adjust  school  activities  to  health  and  growth  needs  and 
to  development  processes  and  to  attend  to  all  matters  pertain- 
ing to  school  hygiene. 

3.  To  bring  about  a  special  study  of  mental  retardation  and 
deviation  of  pupils  in  the  public  schools. 

Sec.  3.  The  requirements  for  certification  of  members  of  the 
examining  staff  for  health  and  development  supervision  in  the 
public  schools  of  the  state  shall  be  as  follows: 

For  educators:  A  life  diploma  of  California  of  the  high  school 
or  grammar  school  grade  and  a  health  and  development  certificate 
which  shall  authorize  the  holder  of  such  certificate  to  conduct 
the  work  authorized  by  this  act,  in  those  grades  specified  by  the 
life  diploma  held. 

For  physicians:  A  California  certificate  to  practice  medicine 
and  surgery  and  a  health  and  development  certificate. 

Sec.  4.  County  or  city  and  county  boards  of  education  are 
hereby  authorized  to  grant  health  and  development  certificates 
to  holders  of  life  diplomas  of  California  of  the  high  school  or 
grammar  school  grade  or  to  holders  of  California  certificates 
to  practice  medicine  and  surgery  who  shall  present  with  such 
life  diplomas  or  with  such  certificates  to  practice  medicine  and 
surgery  a  recommendation  from  the  state  board  of  education 
certifying  special  fitness  for  the  work  specified  in  this  act. 


14 


Colorado 

An  Act  Providinc;  for  thk  Exa^mination  and  Care  of  Chil- 
dren IN  THH  Public  Schools,  and  Making  an  Appro- 
priation IN  Connection  Therewith 

[Enacted  1909] 

Be  it  Enacted  by  the  General  Assembly  of  the  State  oj  Colorado: 

Si:ctu)N  i.  The  State  Superintendent  of  Public  Instruction 
shall  prepare  or  cause  to  be  prepared  suitable  test  cards,  blanks, 
record  books,  and  other  needful  appliances  and  supplies  to  be 
used  in  testing  the  sight,  hearing  and  breathing  of  pupils  in  the 
public  schools,  and  the  necessary  instructions  for  their  use; 
and  shall  furnish  the  same  free  of  expense  to  every  public  school 
in  the  State.  The  teacher  or  principal  in  every  public  school, 
or  where  there  is  no  principal,  the  county  superintendent,  shall, 
during  the  first  month  of  each  school  year,  test  the  sight,  hearing 
and  breathing  of  all  pupils  under  his  charge;  such  examination 
to  be  made  by  observation,  without  using  drugs  or  instruments, 
and  without  coming  in  contact  with  said  child;  and  keep  a 
record  of  such  examinations  according  to  the  instructions  furnished 
and  make  a  written  report  of  such  examinations  to  the  State 
Superintendent  of  Public  Instruction  as  he  may  require. 

Sec.  2.  Every  teacher  in  the  public  schools  shall  report  the 
mental,  moral  and  physical  defectiveness  of  any  child  under 
his  supervision,  as  soon  as  such  defectiveness  is  apparent,  to  the 
principal  or,  where  there  is  no  principal,  to  the  county  superin- 
tendent. Such  principal  or  county  superintendent  shall  promptly 
notify  the  parents  or  guardian  of  each  child  found  to  be  defective, 
of  the  child's  defectiveness,  and  shall  recommend  to  such  parents 
or  guardian  that  such  child  be  thoroughly  examined  as  soon  as 
possible  by  a  competent  physician  or  surgeon  with  special  refer- 
ence to  the  eyes,  ears,  nose,  throat,  teeth  and  spine. 

If  the  parents  or  guardian  of  such  child  shall  fail,  neglect  or 
refuse  to  have  such  examination  made  and  treatment  begun 
within  a  reasonable  time  after  such  notice  has  been  given,  the 
said  principal  or  superintendent  shall  notify  the  State  Bureau 
of  Child  and  Animal  Protection  of  the  facts;  Providing,  however, 
that  whenever  it  shall  be  made  to  appear  to  the  said  principal 
or  superintendent,  upon  the  written  statement  of  the  parent  or 
guardian  of  said  child,  that  such  parent  or  guardian  has  not 


15 

the  necessary  funds  wherewith  to  pay  the  expenses  of  such 
examination  and  treatment,  the  said  principal  or  superintendent 
shall  cause  such  examination  and  treatment  to  be  made  by  the 
county  physician  of  the  district  wherein  said  child  resides;  and 
it  shall  be  the  duty  of  such  county  physician  to  make  such  ex- 
amination and  treatment,  and  if  he  be  unable  to  properly  treat 
such  child  he  shall  forthwith  report  such  fact  to  the  county 
commissioners  of  the  county  with  his  recommendation. 

Sec.  3.  The  State  Auditor  is  hereby  directed  to  draw  his  order 
for  such  sums  and  at  such  times  as  the  State  Superintendent 
of  Public  Instruction  may  require  to  carry  out  the  provisions  of 
this  act.  The  total  expenses  under  this  act  shall  not  exceed 
one  thousand  ($1,000.00)  dollars  in  any  biennial  period  ending 
November  30. 


Connecticut 

Chapter  XXI. — Health,  Sanitation,  and  Safety 

General  Statutes,  Chapter  131,  page  563 
[Enacted  1907] 

Sec.  2QS.  The  board  of  school  visitors,  board  of  education,   1907  ch  207  ?i 

.  .  Appointment  of 

or  town  school  committee  of  any  town,  or  the  board  of  educa-  school 

physicians 

tion  or  committee  of  any  school  district,  may  appomt  one  or 
more  school  physicians  and  assign  one  to  any  public  school 
within  the  limits  of  such  town  or  school  district,  and  shall  pro- 
vide such  school  physicians,  when  so  appointed,  with  proper 
facilities  for  the  performance  of  their  duties. 

Sec.  294.  Every  school  physician    so   appointed    shall    make  1907  ch  207  I2 
a.  prompt  examination  of  all  children  referred  to  him  as  here- 
inafter  provided,    and    such    further   examination    of   teachers, 
janitors,  and  school  buildings  as  in  his  opinion  the  protection 
of  the  health  of  the  pupils  may  require. 

Sec.  295.  The  superintendent,  principal,  or  teacher  of  any  '""['^^  ^°''  P 
school  to  which  a  school  physician  has  been  assigned  as  herein-  referred  to  phy- 

.  .    .  .  sicians  for 

before  provided  shall  refer  to  such  physician  every  child  return-  examination 
ing  to  school  without  a  permit  from  the  health  officer  or  board 
of  health,  after  absence  on  account  of  illness  or  from  unknown 
cause,  and  every  child  attending  such  school  who  appears  to  be 
in  ill  health,  or  is  suspected  to  be  sick  with  any  contagious 
or  infectious  disease,  unless  such  child  be  immediately  excluded 


1 6 

fnnu  siii'li  school  iiikKt  tlie  iM-o\isioiis  of  die  general  statutes 
or  the  sanitar\'  regulations  in  force  in  said  town  or  district; 
pro\ided,  that  in  the  case  of  schools  in  remote  and  isolated  loca- 
tions the  schm)l  committee  may  make  such  other  arrangements 
as  may  he  advisable  to  carry  out  the  purposes  of  this  act. 
AwJuIi'eMm-'''  ^'■•^"-  ^^>^'-  ^^^^'  school  authorities  of  any  town  or  school  dis- 
ISuw?^"'  trici  which  has  ajipointed  a  school  physician  in  accordance  with 

the  pro\isions  of  this  act  shall  cause  every  child  attending  the 
public  schools  therein  to  be  separately  and  carefully  tested  and 
examined  at  least  once  in  every  school  \ear  to  ascertain  whether 
such  child  is  suffering  from  defective  sight  or  hearing,  or  from 
any  other  physical  disability  tending  to  prevent  such  child  from 
receiving  the  full  benefit  of  school  work,  or  requiring  a  modi- 
fication of  such  school  work  in  order  to  prevent  injury  to  the 
child  or  to  secure  the  best  educational  results. 
1907  ch  207  55       Sec.  297.  Notice  of  the  disease  or  defects,  if  any,  from  which 

Notict  of  dis-  -"  . 

ease  to  be  civen  any  child  is  found  bv  such  school  physician  to  be  suffering  shall  be 

to  parent  or  •'  -  f     ^  o  ^ 

guardian  given  to  the  parent  or  guardian  of  such  child  with  such  advice 

or  order  relating  thereto  as  said  physician  may  deem  advisable, 
and  whenever  any  child  shows  symptoms  of  any  contagious 
or  infectious  disease  notice  shall  also  be  given  to  the  health 
ofificer  or  board  of  health  and  such  child  may  be  excluded  from 
attendance  at  such  school  in  accordance  with  the  provisions  of 
the  general  statutes  or  the  sanitary  regulations  in  force  in 
the  town  or  district. 
A?ii>immeJt  of  ^^^-  ^9^-  ^Vhenever  the  board  of  school  visitors,  board  of 
aune^°^  education,  or  town  school  committee  of  any  town,  or  the  board 

of  education  or  district  committee  of  any  school  district,  shall 
have  appointed  a  school  physician  as  provided  in  Sec.  293,  said 
board  or  committee  may  also  appoint  a  matron  or  nurse  who 
shall  take  such  action,  under  the  direction  of  the  school  physi- 
cian, as  may  be  necessary  for  safeguarding  the  health  of  the 
pupils  and  teachers  of  the  schools.  Such  matron  or  nurse  shall 
also  act,  under  the  direction  of  the  school  physician,  as  a  visit- 
ing nurse  in  the  town  or  school  district,  shall  visit  the  homes 
of  pupils  in  the  public  schools,  and  shall  assist  in  executing  the 
orders  of  the  school  physician. 
E^tit^'hlw'  Sec.  299.  The  expenses  incurred  under  the  provisions  of  this 
^^  act  shall  be  paid  in  the  same  manner  as  are  the  ordinary  expenses 

for  the  support  of  schools  in  the  several  towns  and  school  dis- 
tricts. 


17 


District  of  Columbia 

Regulations  Governing  the  Medical  Inspection  of  Public 

Schools 

Promulgated  in  accordance  with  an  Act  making  appropriations 
to  provide  for  the  expenses  of  the  Government  of  the  District  of 
Columbia,  approved  March  3,  1903. 

Formulated  by  the  Health  Officer,  June  30,  1903. 

Approved  by  the  Board  of  Education,  June  30,  1903. 

Approved  by  the  Commissioners  of  the  District  of  Columbia, 
July  14,  1903. 

Amended  by  the  Health  Officer,  July  7,  1907. 

Approved  by  the  Board  of  Education,  October  9,  1907. 

Approved  by  the  Commissioners  of  the  District  of  Columbia, 
December  7,  1907. 

Section  i.  No  pupil  will  be  permitted  to  attend  the  public  vvhen  pupils 
schools  of  the  District  of  Columbia  who  is  suffering  from  any  f^^^  schooi.^*^' 
defect  or  disease  which  renders  his  presence  materially  detri- 
mental to  the  welfare  or  the  safety  of  other  pupils,  nor  will  any 
pupil  be  permitted  to  attend  school  when  such  attendance  will 
materially  jeopardize  his  own  health  and  the  condition  out  of 
which  such  jeopardy  arises  is  of  a  temporary  character. 

Sec.  2.  Every  teacher,  immediately  alter  the  opening  of  school  Teacher    shaii 
each  day,  will  carefully  observe  the  general  expression  and  con-  dit1"n  ^  o f°"  pu- 
dition  of  every  pupil  and  determine  whether  any  of  them  present  "''*  ^^''^" 
appearance   suggestive   of   the   advisability   of  exclusion   under 
the  provisions  of  these  regulations. 

Sec.  3.  Every  teacher,  within  one-quarter  hour  after  the  open-  Teacher  shaii 
ing  of  school  each  day,  will  forward  to  the  principal  of  the  q°,Mr''for^  ex- 
building  in  which  she  teaches,  a  written  request  on  the  form  "'"'"^"°"- 
provided  for  that  purpose,   for  the  examination  by  a  medical  casor^or    ex- 
inspector,  of  each  pupil  under  his  care  who  belongs  or  appears  ^"""^'^'°"- 
to  belong  to  any  of  the  following  classes: 

Class  A.  Pupils  whose  appearances,  or  known  or  suggested  Kxciusion  of 
histories,  indicate  that  they  may  be  suffering  from  conditions  gcs'ted."'"^ 
rendering  their  exclusion  from  school  necessary  under  the 
provisions  of  these  regulations. 

Class  B.  Pupils  who  have  returned  after  having  been  Pupna  return- 
excluded  from  school  on  the  recommendation  of  the  Health  dusion.*^^"^  ^*" 
Officer,  or  of  a  medical  inspector,  except  excluded  pupils 


i8 


tot    tivr   ot 
tnorr     i-on»ccu- 


Kmrri;<T>cy 

r\jraia:ttion 

requested. 


rupiU    to    be 
uolaicO. 


Suspected 
cases    o( 
smallpox. 


When   pupils 
may  remain  in 
ciais   room. 


Principal   to 
notify  in- 
spector. 


Notification 
in  caae  of 
emergency. 


Inspector  to 
respond    on 
day    of 
notice. 


wlui  prc.'itMit  certificates  signed  by  the  Health  Officer  authro- 
izing  their  return;  but  excluded  pupils  whose  return  is 
clearly  ft)rbidiien  by  these  regulations  are  not  to  be  referred 
to  tlie  inetlical  inspector  for  examination,  but  are  to  be  sent 
lionie  at  once. 

Class  C.  Pupils  who  have  been  absent  from  school  without 
cause  for  five  or  more  consecutive  school  days,  unless  the 
teacher  has  reason  to  believe  that  the  absentee  has  not 
suffered  from  or  been  exposed  to  a  communicable  disease. 

Requests  for  the  examination  of  pupils  may,  however,  be 
made  out  and  forwarded  to  the  principal  for  appropriate 
action,  in  case  of  emergency,  at  any  time  during  the  school 
day. 
Sec.  4.  Any  teacher  belie\ing  that  a  pupil  in  his  class  is  suffer- 
ing from  a  communicable  disease  must  bring  the  case  to  the  atten- 
tion of  the  principal  of  the  building,  and  the  principal  must 
isolate  the  pupil,  as  well  as  the  facilities  at  his  command  will 
permit,  pending  the  arrival  of  the  medical  inspector  and  instruc- 
tion from  him  as  to  the  disposal  of  the  case;   or  if  the  case  be 
an  urgent  one,  such  for  instance  as  a  suspected  case  of  smallpox, 
the  principal  must  submit  the  facts  to  the  Health  Officer  at  once, 
by  telephone  or  by  messenger,  and  dispose  of  the  case  in  such 
manner  as  the  Health  Officer  directs. 

Sec.  5.  A  teacher  may,  in  her  discretion,  permit  a  pupil  who 
is  not  suspected  of  having  a  communicable  disease  to  remain 
in  the  class  room  pending  the  arrival  of  a  medical  inspector. 

Sec.  6.  Every  principal  of  a  school  will  notify  the  medical 
inspector  assigned  to  such  school  whenever  the  services  of  a 
medical  inspector  are  required.  With  respect  to  the  examination 
of  pupils  attending  all-day  classes  or  morning  classes  such  noti- 
fication must  be  given  not  later  than  half  past  nine  o'clock, 
and  notification  with  respect  to  pupils  attending  afternoon 
classes  must  be  given  not  later  than  half  past  one  o'clock. 
If,  however,  a  principal  fails  to  notify  the  inspector  within  the 
allowed  time,  he  must  notify  him  as  soon  thereafter  as  possible, 
and  in  case  of  emergency  notification  may  be  given  at  any  time. 
Sec.  7.  Every  medical  inspector,  upon  receiving  notice  that 
his  services  are  required  at  any  of  the  schools  to  which  he  has 
been  assigned,  will  respond  to  such  notice  on  the  day  of  its 
receipt  and  as  soon  after  its  receipt  as  is  practicable. 


19 


Sec.  8.  Every  medical  inspector  will  devote  to  actual  inspec- 
tion work  each  school  day  not  less  than  three  hours.  He  will 
first  visit  each  school  from  which  he  has  received  notice  to  call 
and  do  whatever  may  be  necessary  there.  If  thereafter  any 
part  of  the  required  three-hour  period  remains,  the  inspector 
will  devote  it  to  the  making  of  routine  examinations  at  schools 
as  hereinafter  described. 

Sec.  9.  When  a  medical  inspector  calls  at  a  school  in  response 
to  a  request  for  his  services  he  will  immediately  procure  from  the 
principal  the  reports  made  by  teachers  in  compliance  with  the 
requirements  of  Section  4  of  these  regulations.  Then,  with  the 
cooperation  of  the  principal,  and  in  his  presence  or  in  the  presence 
of  a  teacher  detailed  by  the  principal  for  that  purpose,  he  will 
examine  all  such  pupils  as  are  brought  to  his  attention  for  that 
purpose.  In  so  doing  he  will  afford  the  principal  and  teachers 
every  opportunity  to  observe  the  evidence  and  to  learn  the  reason 
upon  which  he  bases  his  recommendation,  so  that  the  principal  and 
teachers  may  be  better  able  thereafter  to  select  from  among  the 
pupils  under  their  care  those  who  by  reason  of  defect  or  disease 
are  unfit  to  attend  school.  In  the  making  of  such  examinations 
the  principal  and  teachers  will  assist  the  inspector  in  every  pos- 
sible way.  All  examinations  are  to  be  made  with  the  utmost 
possible  privacy  and  in  no  case  is  the  examination  of  an  individual 
pupil,  as  distinguished  from  the  examination  of  an  entire  class, 
to  be  made  in  the  class  room  in  the  presence  of  other  pupils. 

Sec.  10.  The  medical  inspector  will  indorse  on  the  forms  which 
have  been  made  out  by  the  teacher  (Form  A)  his  tentative 
diagnoses  and  his  recommendations.  Notes  of  the  subjective 
and  objective  symptoms  upon  which  the  inspector  bases  his 
recommendations  for  the  exclusion  of  a  pupil  from  school  should 
be  made,  if  the  inspector  deems  it  necessary,  on  the  duplicate 
form,  but  only  such  notes  should  be  made  in  this  way  as  can  be 
made  without  disclosing  information  essentially  confidential  in 
its  nature. 

The  "Original"  form  the  inspector  will  give  to  the  principal 
of  the  school  for  proper  action.  The  "Duplicate"  he  will 
preserve  and  forward  to  the  Health  Officer  at  the  close  of  the 
day  after  having  made  such  a  memorandum  therefrom  as  may  be 
necessary  to  enable  the  inspector  to  make  out  his  weekly  report. 
The  principal  will  foruard  the  "Original"  to  the  supervising 
principal  as  soon  as  practicable,  except  in  cases  of  exclusion  in 


Inspector   to 
devote  not  less 
than   three 
hours   each 
day    to    inspec- 
tion. 


Order   of 
inspections. 


Inspector  to 
secure    re- 
quests   for    ex- 
amination from 
principal. 

Principal  to  be 
represented  at 
examination. 


Teachers  to 
observe  evi- 
dence   at    time 
of  examination. 


Teachers  to 
assist      in     e 
amination. 
Examination 
to   be   made 
in  private. 


Inspector   to 
indorse      tenta- 
tive    diagnoses 
and   recom- 
mendations   on 
request. 


Duplicate    re- 
quest   to    be 
sent   to   Health 
Officer. 


Original  re- 
quest   to    be 
sent    to    super- 
vising   prin- 
cipal. 


20 


iAtr>      .".'.       rr- 
coinmrnJittions. 


AppcuU   of 
pniK'i|>al     (ro!i; 
drv'ision  of 
iiMt>ev"tor. 


Routine      visits 
of    in:>p«ctor. 


Inspector  to 
confer  with 
principal. 


Inspector  to 
visit    classes. 


Inspector   to 
call       attention 
to   sick   or   de- 
fecti%-e     pupils. 


which  cast's  [he  "Oriijinal "  shtniUl  be  retained  by  the  principal 
until  after  the  pupil  has  been  reailniitted  or  his  name  erased  from 
the  school  roll. 

SiA.  II.  riie  teacher  of  the  school  in  cooperation  with  the 
principal  will  carry  out  the  recommendations  of  the  medical 
insjxjctor  as  promptly  as  possible. 

Si'X.  12.  Should  any  principal  desire  to  appeal  from  the  decision 
of  the  inspector,  he  will  first  carry  out  the  recommendations  of 
such  inspector,  and  after  having  done  so  address  his  appeal,  in 
writing,  to  the  supervising  principal  of  the  division  to  which  he 
is  assigned.  The  supervising  principal  may  undertake  to  adjust 
the  case  by  conferring  with  the  Health  Officer,  either  directly  or 
through  the  superintendent  of  public  schools. 

Sec.  13.  a  medical  inspector,  in  determining  w'hich  of  the 
schools  under  his  supervision  shall  be  visited  on  any  particular 
day  independently  of  requests  for  his  services,  will  take  into 
consideration  the  length  of  time  that  has  elapsed  since  each 
of  the  various  schools  under  his  supervision  has  been  visited, 
whether  on  special  calls  or  on  routine  visits,  and  will  endeavor 
to  arrange  his  routine  visits  so  that  each  of  the  schools  assigned 
to  him  will  receive  an  equal  amount  of  attention.  Routine 
visits  may  be  made  during  either  the  morning  or  the  afternoon 
sessions  of  school,  as  best  suits  the  convenience  of  the  medical 
inspector,  but  visits  to  any  one  school  in  which  classes  are  held 
both  in  the  forenoon  and  in  the  afternoon  should  not  be  con- 
tinuously limited  either  to  the  morning  or  afternoon  sessions. 

Sec.  14.  A  medical  inspector,  upon  visiting  a  school  for  the 
purpose  of  making  a  routine  inspection,  will  confer  with  the 
principal  and  advise  him  w^ith  reference  to  all  such  matters  of 
hygiene  or  sanitation  as  may  be  brought  to  the  inspector's 
attention.  At  each  such  visit  the  inspector,  with  the  principal 
of  the  school,  or  without  him,  if  the  principal  prefers,  will  go  to 
one  or  more  of  the  class  rooms  and  to  other  parts  of  the  building 
and  observe  the  physical  condition  of  the  pupils  and  rooms  and 
of  the  building  generally.  During  such  inspections  the  inspector 
will  take  occasion  to  invite  the  attention  of  the  principal  and 
teachers  to  such  apparently  sick  or  defective  pupils  as  he  may 
observe  and  to  such  conditions  in  the  room  and  in  the  building 
generally  as  require  correction,  so  that  appropriate  action  may 
be  taken  and  similar  conditions  avoided  in  the  future. 


21 

Inspectors  are  cautioned  that  they  are  not  to  act  as  advisers  inspectors  only 
of  principals  and  teachers,  except  on  matters  peculiar  to  the  v*isers  !n  medi- 
medical   profession,   and  are  not  to  assume  the  role  of  critics  '^^^  matters. 
merely.     Under   no   circumstances   should   advice   be   given   or 
remarks  made  in  the  presence  of  pupils,  which  can  be  either 
construed  or  misconstrued  as  reflections  on  the  school  manage- 
ment.    Any  apparent  dereliction   on   the   part  of   any  janitor 
should  be  brought  privately  to  the  attention  of  the  principal  of 
the  building  in  which  such  janitor  is  employed,  so  that  appro- 
priate action  may  be  had. 

Sec.  15.  Should  occasion  require  the  making  of  a  special  Special  inspec- 
inspection  of  all  the  pupils  in  any  class  or  classes,  as,  for  instance,  pupils  in  a 
for  the  purpose  of  determining  whether  any  of  them  are  or  are 
not  suffering  from  scarlet  fever  or  pediculosis,  the  inspector  will 
invite  the  principal  to  accompany  him,  and  then,  either  with  or 
without  the  principal,  will  proceed  to  the  class  or  classes  to  be 
examined.  There  the  inspector  will  look  over  the  pupils  in  a 
general  way,  but  will  make  no  physical  examination  of  individual 
pupils  in  the  class  room.     If,  in  the  course  of  such  examination,  Order  of 

.      ,  ,  ,  .  .  P  ...       special     inspec- 

it  becomes  apparent  that  a  closer  exammation  01  any  pupil  is  tion. 
desirable,  the  teacher  will,  on  the  request  of  the  inspector,  send 
such  pupil  to  some  proper  place  in  the  building  where  such  ex- 
amination can  be  made  as  the  inspector  deems  necessary.  For 
each  pupil  set  aside  for  special  examination  the  teacher  will 
make  out  the  usual  request  for  examination  as  provided  by  Sec- 
tion 3  of  these  regulations. 

In  connection  with  the  examination  of  the  pupils  of  any  class  special  inspec- 
for  the  purpose  of  detecting  the  presence  of  pupils  suffering  from  scarlet" fevlr.  °^ 
scarlet  fever,  the  pupils  may  be  required  to  raise  their  hands  so 
as  to  permit  the  easier  and  more  rapid  examination;  but  in 
such  cases  the  inspector  must  be  careful  to  avoid  touching  in 
any  way  the  pupils  under  examination,  at  least  until  after  their 
removal  to  the  examination  room,  and  then  if  it  becomes  neces- 
sary to  touch  or  handle  any  pupil,  and  that  pupil  is  found  to 
have  scarlet  fever  the  inspector  will  carefully  disinfect  his  hands 
before  proceeding  to  the  examination  of  other  pupils. 

Sec.  16.  The  teacher  will  give  to  each  pupil  whopi  she  excludes  Kive*^  pupii° 
from  school  a  proper  notice,  showing  the  reason  for  exclusion  "lus'io'n  ?n 
and  the  conditions  upon  which  he  will  be  allowed  to  return.  ''""""■ 
And   if  a   pupil,   although    not   formally   excluded   in    the   first 
instance,  is  known  to  be  absent  because  of  conditions  which,  if  .xc'iu'^ion^'i's'' t"o 

be      mailed      to 
parent. 


22 


Differences  be- 
»»iT-n  in»i>ec- 
tors  and  pa- 
n-tit*, etc..  to 
Ik-  rrfenrd  to 
Health    OflScer. 


TiM'licrs    not 
to    [).•>  omo 
p.iriii>    to 
controversy. 


Exclusion    for 
Kriii;-'.    Ger- 
man   measles, 
communicable 
diseases  of  eye, 
para;9itic    dis- 
ease of  hair  or 
skin,  and  other 
conditions     not 
afTecting  health 
of  other  pupils. 

Return   after 
exclusion. 


Pupil   to  be 
referred    to 
inspector   lor 
examination  on 
day    of    return. 


Return     after 
exclusion     for 
smallpox. 
Bcarlei    fever, 
diphtheria, 
measles, 
whooping 
cough, 

chiclcenpox  and 
epidemic  cere- 
bro-spinal  men- 
ingitis. 


he  wiMV  in  attcndanco.  would  justify  his  exclusion,  the  teacher 
will  send  a  like  notice  to  the  parent  or  guardian  of  such  pupil 
and  will  j;ive  a  duplicate  thereof  to  the  inspector  at  the  time  of 
his  next  visit.  When  an  excluded  pupil  has  complied  with  the 
coniliiions  necessary  to  entitle  him  to  rcadmission  to  school  the 
teacher  will  for\vard  the  exclusion  blank  returned  by  the  pupil 
and  containing  e\idence  of  such  compliance  through  the  principal 
to  the  sujx^rvising  princijjal. 

SiiC.  17.  In  event  of  differences  of  opinion  between  a  medical 
inspector  and  the  parent,  guardian  or  family  physician  of  any 
pupil  relative  to  the  necessity  for  exclusion  of  the  pupil  from 
school,  the  teacher  will  refer  the  parent  or  guardian  to  the  Health 
Officer,  and  if  the  circumstances  in  his  judgment  so  require,  will 
report  the  facts  of  the  case  to  the  supervising  principal.  Under 
no  circumstances  wdll  teachers,  principals  of  schools,  medical 
inspectors  or  supervising  principals,  allow  themselves  to  become 
parties  to  a  contro\'ersy  in  matters  of  this  kind,  but  all  such 
matters  must  be  settled  by  conference  between  the  parent  or 
guardian  and  the  Health  Officer. 

Sec.  18.  A  pupil  who  has  been  excluded  from  school  because  of 
conditions  not  affecting  or  liable  to  affect  the  health  of  other 
pupils,  or  because  of  grippe,  German  measles,  communicable 
disease  of  the  eye,  or  parasitic  disease  of  the  hair  or  skin,  may  be 
permitted  to  return  to  school  at  any  time  after  the  expiration  of 
the  period  specified  in  the  notice  of  exclusion.  He  may  be  per- 
mitted to  return  sooner  if  he  presents  a  certificate  from  a  law- 
fully practicing  physician  showing  that  in  the  judgment  of  such 
physician  he  can  return  with  safety  to  himself  and  if  the  pupil 
has  suffered  from  the  grippe,  German  measles,  communicable  dis- 
ease of  the  eye,  or  parasitic  disease  of  the  skin  or  hair,  that  the 
communicability  of  the  disease  has  passed.  But  every  such 
pupil  must  be  reported  to  the  medical  inspector  for  examination 
on  the  day  of  the  pupil's  return  to  school.  After  having  re- 
ported the  case  the  principal  and  the  teacher  will  be  guided  in 
their  future  action  by  whatever  recommendation  the  medical  in- 
spector makes. 

Sec.  19.  The  return  of  a  pupil  to  school  after  he  has  suffered 
from  or  been  exposed  to  smallpox,  scarlet  fever,  diphtheria, 
measles,  whooping  cough,  chickenpox  and  epidemic  cerebro- 
spinal meningitis,  is  regulated  primarily  by  an  Act  to  prevent 
the  spread  of  contagious  diseases  in  the  District  of  Columbia, 


23 


approved  March  3,  1897;  an  Act  for  the  prevention  of  scarlet 
fever,  diphtheria,  measles,  whooping  cough,  chickenpox,  epi- 
demic cerebro-spinal  meningitis  and  typhoid  fever  in  the  District 
of  Columbia,  approved  February  9,  1907,  and  the  regulations  for 
the  prevention  of  the  diseases  just  named,  promulgated  by  the 
Commissioners  by  authority  of  the  latter  act,  pertinent  extracts 
from  which  laws  and  regulations  appear  on  pages  60  to  62.  In 
order,  however,  that  the  health  of  pupils  attending  public  schools 
may  be  further  safeguarded  no  pupil  who  has  suffered  from 
measles  will  be  permitted  to  return  to  school  until  after  the 
expiration  of  three  weeks  from  the  onset  of  the  disease ;  no  pupil 
suffering  from  whooping  cough  until  after  the  expiration  of  five 
weeks;  no  pupil  suffering  from  chickenpox  until  after  the  expira- 
tion of  two  weeks,  and  no  pupil  suffering  from  mumps  until  after 
the  expiration  of  three  weeks. 

A  pupil  who  has  suffered  from  smallpox,  scarlet  fever,  or 
diphtheria  may  be  permitted  to  return  at  any  tirhe,  but  only  on 
the  presentation  of  a  certificate  issued  by  the  Health  Officer 
authorizing  him  so  to  do.  No  such  certificate  will  be  required 
from  pupils  who  have  suffered  from  measles,  whooping  cough, 
chickenpox,  mumps,  grippe,  German  measles,  communicable 
disease  of  the  eye  and  parasitic  diseases  of  the  skin  and  hair, 
but  every  such  pupil  must,  on  the  day  of  his  return,  be  reported 
to  the  medical  inspector  for  examination.  Pupils  returning  after 
smallpox,  scarlet  fever  and  diphtheria,  and  provided  with  certifi- 
cates from  the  Health  Officer,  need  not  be  so  referred,  and  if  not 
provided  with  such  certificate  they  should  be  sent  home  imme- 
diately. Pupils  who  are  not  suffering  from  mumps  but  have 
merely  been  exposed  to  that  disease  need  not  be  excluded  from 
school. 

Sec.  20.  If  any  pupil  be  excluded  from  school  because  of  sus- 
pected communicable  disease  only,  the  medical  inspector  will 
visit  such  pupil  on  the  day  following  his  exclusion  for  the  pur- 
pose of  confirming  or  disproving  his  tentative  diagnosis.  If  at 
the  time  of  such  visit  he  finds  a  physician  in  attendance  on  the 
case,  he  will  retire  without  examining  the  patient,  unless  he  is 
requested  by  the  attending  physician  to  do  so. 

Sec.  21,  Whenever  a  pupil  is  excluded  from  school  on  account 
of  communicable  disease,  the  medical  inspector  will  recommend 
such  disinfection  as  in  his  judgment  is  necessary.  Ordinarily 
the  seat  and  desk  of  the  infected  pupil  nmst  be  washed  with  a 


Period  of 
exclusion   for 
measles. 
Period  of 
exclusion   for 
whooping 
cough. 
Period   of 
exclusion    for 
chickenpox. 
Period   of 
exclusion    for 
mumps. 


Certificate  of 
Health  Officer 
required   in 
cases   of   small- 
pox,   scarlet 
fever    and 
diphtheria. 
When    no    cer- 
tificate is  to  be 
required. 


Pupil    to    be 
referred  to 
inspector    for 
examination. 
When    pupil    is 
not    to    be    re- 
ferred     to      in- 
spector. 

Pupil    not    to 
be   excluded 
for    exposure 
to    mumps. 


Inspector    to 
visit     pupil 
after   exclusion. 


Inspector  to 

recommend 

disinfection. 


24 


Pimnfcvtion 
(•>   »»•  ilont-   by 


nisijnfrT-tion 
•  <l    building. 


Disinfcv'lion  by 
Health  Office. 

Employees  to 
a.ssist     in     dis- 
infection   of 
building. 


Detailed   list 
of    school 
property 
destroyed    to 
be    furnished. 


Closing    of 
a   school 
building. 


Superinten- 
dent of  schoola 
to    be    notified. 


Superinten- 
dent of  schools 
to   issue 
instructions. 


Inspectors    to 
examine 
teachers   or 
janitors. 


proi>or  disinfecting  solution;  pen-holders,  pencils,  etc.,  which 
have  been  in  the  possession  of  the  pupil  must  be  treated  in  the 
s.uue  manner  if  they  cannot  be  destroyed.  In  some  cases  it 
will  Ih^  necessary  to  wash  the  handrails  of  stairways,  doorknobs, 
etc.  Work  of  this  kind  must  be  done  by  the  janitor  of  the  school 
building.  Disinfection  of  books,  when  necessary,  will  be  done 
by  employees  of  the  Health  Department. 

Sec.  22.  Whenever  in  the  judgment  of  the  medical  inspector,  a 
school  building  or  part  thereof  requires  disinfection  over  and 
beyond  that  which  can  be  done  by  the  janitor  of  such  building, 
the  medical  inspector  will  so  notify  the  Health  Ofificer  at  the 
earliest  possible  moment.  Whether  such  disinfection  shall  or 
shall  not  be  done  will  be  determined  by  the  Health  Ofificer  or 
by  the  inspector  in  charge  of  the  contagious  disease  service 
after  due  consideration  of  all  facts  in  the  case.  If  such  disinfec- 
tion be  done,  it  will  be  undertaken  primarily  by  employees  in 
the  service  of  the  Health  Department,  but  all  persons  connected 
with  the  school  building  to  be  disinfected  will  render  such  assis- 
tance as  may  be  practicable. 

Sec.  23.  The  Health  Ofificer  will  furnish  the  superintendent 
of  public  schools  with  a  detailed  statement  of  all  school  property 
destroyed  because  of  infection  and  a  certificate  showing  the 
necessity  for  such  action. 

Sec.  24.  If,  in  the  judgment  of  a  medical  inspector,  any  school 
building  or  part  thereof  should  be  closed  he  will  forthwith  make 
a  recommendation  to  that  effect  to  the  Health  Ofificer,  who  will 
determine  what  action  should  be  taken  and  recommend  accord- 
ingly. Recommendations  of  the  Health  Ofificer  looking  toward 
the  closing  of  any  school  building  or  part  thereof  will  be  communi- 
cated directly  to  the  ofifice  of  the  superintendent  of  public  schools 
or  to  his  residence,  if  it  be  found  impracticable  to  communicate 
with  his  ofifice.  The  superintendent  of  public  schools  will 
thereupon  become  responsible  for  all  further  action  looking 
toward  the  closing  of  any  such  school  building  or  part  thereof. 
Teachers  and  principals  will  be  governed  by  such  instructions 
as  they  receive  from  the  superintendent  of  public  schools. 

Sec.  25.  A  medical  inspector  will,  upon  the  request  of  the 
principal  of  a  school  building,  and  with  the  consent  of  the  teacher 
or  janitor  affected,  examine  any  such  principal,  teacher  or  janitor, 
to  determine  the  advisability  of  such  principal,  teacher  or  janitor 
continuing  his  school  duties.     Reports  and  recommendations  in 


25 

cases  of  teachers  and  janitors  will  be  addressed  to  the  principal 
of  the  school  building,  and  in  the  case  of  principals  will  be 
addressed  to  the  proper  supervising  principal.  All  such  reports, 
however,  will  be  delivered  by  the  medical  inspector  to  the  princi- 
pal of  the  school  building. 

Sec.  26.  This  exclusion  of  teachers  and  janitors  from  schools  fea'^chlrg'*  and 
and  the  resumption  by  them  of  their  school  duties  will  be  de-  J^^i^tors. 
termined  in  accordance  with  these  regulations  so  far  as  they  may 
be  applicable. 

Sec.  27.  In  the  event  of  the  occurrence  of  any  emergency  ^™e^s'^°fo"^be 
requiring  medical  aid,  the  principal  of  the  building  will  call  at  reponed!^^'^ 
once  upon  the  medical  inspector  assigned  to  such  building. 
If  unable  to  secure  his  services  with  reasonable  promptness,  he 
will  communicate  with  the  Health  Department,  which  will 
arrange  for  the  services  of  another  inspector,  or,  in  some  other 
manner  supply  the  needed  assistance. 

Sec.  28.  Medical  inspectors  will  respond  promptly  to  all  calls  inspector 
coming  from  any  of  the  school  buildings  under  their  care,  or  promptly  to 

...  ,  emergency 

from  the  Health  Department,  for  aid  in  any  case  of  emergency  caiis. 
requiring  medical  care. 

Sec.  29.  Examination  of  applicants  for  admission  to  the  normal  f mlnation' at 
school,  of  pupils  in  that  school  seeking  graduation,  and  of  appli-  ^^^^^^^  °/ 
cants   for   appointment   as   teachers   or   janitors,   to   determine  Education. 
their  physical  fitness  for  admission,  graduation  or  appointment, 
will  be  made  when  requested  by  the  Board  of  Education  by  a 
medical  inspector  or  medical  inspectors  of  schools  detailed  for 
that  purpose  by  the  Health  Officer. 

Sec.  30.  Medical  inspectors  will  note  such  unsanitary  conditions  note^'^g^nd  're- 
in and  about  school  buildings  as  may  be  called  to  their  attention  conditkms!"^^'^^ 
or  as  may  come  under  their  personal  observation,  and  will  report 
them  to  the  Health  Officer.  The  Health  Officer,  if  such  condi- 
tions arise  from  property  under  the  control  of  the  Board  of 
Education,  will  report  them  to  that  board,  and  to  the  Engineer 
Department.  Inspectors  will  bear  in  mind  that  they  are  not 
to  act  as  mere  agents  for  the  transmission  of  complaints  of  the 
cause  of  which  they  have  no  personal  knowledge. 

Sec.  31.  Each  day,  as  soon  as  possible  after  leaving  the  last  n"tiJ*^'^dl[pii^te 
school  to  be  visited,  inspectors  will  mail  to  the  Health  Officer  the  Health  officer, 
duplicate  slips  showing  tentative  diagnoses  and  recommendations 
which  they  have  made  during  the  day   (Form  A,   Duplicate). 
Before  doing  so,  however,  they  will  note  for  use  in  the  preparation 


26 


iniornmiion. 


In«fwvtor»       to 
IxTlorm       such 
aiUlitional 
duties     as     di- 
nvtpd    !>>■ 
Health  Officer. 


Inspector     to 
report    to 
Health  Officer 
in   case   of 
illness. 


Inspectors    to 
report    to 
Health  Officer 
when  directed. 


Jurisdiction    of 
inspectors. 


Inspectors  not 
to  treat  ex- 
cluded, pupils. 


of  tlu'ir  \\iH'kl\-  ri>porl  (I'orni  1))  such  data  as  may  be  necessary 
(or  that  inir|H)so. 

Si-X".  32.  Kvcr>-  t)rricer  and  agent  of  the  Health  Department 
and  of  the  Board  of  Ekliication  will  be  held  strictly  accountable 
for  any  unwarrantable  tlisclosurc  of  information  acquired  in  his 
otVicial  capacitN'.  A  medical  inspector  of  public  schools  does  not 
lose  his  character  as  a  physician  by  reason  of  his  office  and 
therefore  must  not  disclose  any  information  which  is  essentially 
confidential  in  its  character  and  which  he  has  acquired  in  his 
official  capacity,  except  to  those  properly  entitled  to  receive  it. 
No  such  information  should  ever  be  embodied  in  routine  reports, 
but  if  a  report  is  necessary  it  should  be  specially  and  confidentially 
submitted. 

Sec.  33.  Medical  inspectors  will  be  required  to  perform  such 
duties  in  connection  with  the  medical  inspection  of  public  schools, 
in  addition  to  those  specifically  described  in  these  regulations, 
as  may  be  directed  by  the  Health  Officer.  No  physical  examina- 
tion of  the  pupils  of  any  entire  room  or  building  is  to  be  under- 
taken except  so  far  as  may  be  necessary  for  the  detection  of 
communicable  diseases  and  of  defects  of  sight  and  hearing, 
without  the  consent  of  the  Board  of  Education. 

Sec.  34.  If  by  reason  of  illness  or  any  other  cause  the  medical 
inspector  is  unable  to  report  at  schools  under  his  supervision  in 
his  usual  manner,  he  will  communicate  at  once  with  the  Health 
Ofificer,  so  that  proper  arrangements  can  be  made  for  the  per- 
formance of  his  work.  A  written  explanation  of  such  absence 
must  in  each  case  be  forwarded  to  the  Health  Officer  as  soon  as 
practicable. 

Sec.  35.  Medical  inspectors  will  report  at  the  Health  Office 
from  time  to  time  as  may  be  directed  by  the  Health  Officer. 
Special  meetings  of  medical  inspectors  of  schools  may  be  called 
at  other  places  in  the  discretion  of  the  Health  Officer. 

Sec.  36.  The  jurisdiction  of  the  medical  inspector  of  schools 
is  limited  and  defined  by  these  regulations.  Visits  to  pupils 
at  their  homes  or  examinations  of  pupils  there  may  be  made  only 
as  these  regulations  authorize,  and  then  only  with  the  consent  of 
their  parents  or  guardians,  and  if  any  such  pupil  be  under  the 
care  of  a  physician,  the  consent  of  such  physician  also  must  be 
obtained. 

Sec.  37.  Under  no  circumstances  will  a  medical  inspector 
undertake  to  treat  a  pupil,   teacher  or  janitor,   who  has  been 


27 

excluded  from  school  on  his  recommendation  during  the  period 
of  such  exclusion,  unless  such  pupil,  teacher  or  janitor,  or  the 
family  of  such  pupil,  teacher  or  janitor,  has  been  under  the  pro- 
fessional care  of  such  inspector  prior  to  the  occurrence  of  the 
condition  which  led  to  exclusion:    provided,  however,  that  any  when  circulars 

,  ,       .  ,  r  1-       1       •        may    be    given 

Circular  or  circulars  relative  to  the  treatment  ot  pediculosis,  pupils. 
ringAvorm,  or  any  similar  condition  which  the  Health  Officer 
may  furnish  may  be  given  to  pupils  excluded  from  school  because 
suffering  from  such  disease.  Any  effort  to  make  the  office  of 
medical  inspectors  of  schools  a  means  for  increasing  private 
practice  will  lead  to  the  prompt  dismissal  of  the  offender. 

Sec.  38.  Every  principal  of  a  school  will  see  that  there  are  at  feeTJ"^medicai 
all  times  on  hand  in  the  building  under  his  supervision  a  sufficient  supplies. 
supply  of  blanks  of  all  kinds,  tongue  depressors,  disinfectants 
and  proper  receptacles  for  the  disinfecting  solutions,  and  soap, 
towels,  and  a  nail  brush  for  the  use  of  the  inspector.  These 
articles  can  be  obtained  by  applying  to  the  secretary  of  the 
Board  of  Education. 

Medical  inspectors  will  obtain  such  articles  as  are  needed  obtafn'^bianks. 
solely  for  their  use  in  the  keeping  of  their  records  and  the  making  Hea'ith'^officer. 
of  their  reports  by  application  to  the  Health  Officer.  Articles 
needed  for  use  in  connection  with  the  actual  examination  of 
pupils  and  for  the  making  out  of  recommendations,  etc.,  at  school 
buildings,  will  be  supplied  in  all  cases  by  the  principals  of  such 
buildings. 

Sec.  30.  The  word  "he"  and  the  derivatives  thereof  wherever  deriva°/ives. 
used  in  these  regulations  are  to  be  read  to  include  the  word 
"she"  and  its  corresponding  derivatives,  respectively,  and  any 
power  and  authority  conferred  upon  a  principal  or  teacher  in 
and  by  these  regulations  may  be  exercised  by  any  officer  in  the 
service  of  the  Board  of  Education,  having  a  higher  rank,  and 
any  power  and  authority  conferred  upon  a  medical  inspector 
may  be  exercised  by  any  officer  in  the  service  of  the  Health  De- 
partment with  relatively  higher  standing. 


28 


Indiana 

An  Act  to  Pkotixt  and  Conserve  the  Health  and  Lives  of 
School  Chh-dken  and  Promote  Their  Efficiency  by 
Providinc;  for  Their  Medical  Inspection  and  Subse- 
quent Necessary  Treatment 

[Enacted  191 1] 

Section  i.  Be  it  enacted  by  the  General  Assembly  of  the  State 
of  Indiana,  That  all  school  trustees  and  township  trustees  are 
herewith  permitted  and  recommended  to  institute  medical  in- 
spection of  school  children  at  any  time;  the  said  trustees  may  re- 
quire teachers  to  annually  test  the  sight  and  hearing  of  all  school 
children  under  their  charge,  the  said  tests  and  uses  thereof  to  be 
made  according  to  the  rules  hereinafter  authorized. 

Sec.  2.  The  term,  medical  inspection,  as  used  in  this  act,  shall 
be  held  to  mean — the  testing  of  the  sight  and  hearing  of  school 
children  and  the  inspection  of  said  children  by  school  physicians 
for  diseases,  disabilities,  decayed  teeth  or  other  defects,  which 
may  reduce  efficiency  or  tend  to  prevent  their  receiving  the  full 
benefits  of  school  work. 

Sec  3.  Beginning  with  the  school  year  191 1,  school  trustees 
and  township  trustees  may  appoint  at  least  one  school  physician 
for  each  school  corporation:  Provided,  Where  practicable,  two 
or  more  school  corporations  may  unite  and  employ  one  such 
physician,  whose  duties  shall  be  such  as  are  prescribed  in  this  act 
and  the  authorized  rules,  but  not  more  than  2,000  children  shall 
have  a  school  physician.  Said  school  physicians  shall  be  grad- 
uates of  a  medical  college,  recognized  by  the  state  board  of 
registration  and  examination,  shall  hold  a  license  to  practice 
medicine  in  Indiana,  and  shall  be  informed  and  skilled  in  medical 
inspection  of  children,  informed  in  the  health  laws  and  the  health 
rules  of  the  state  board  of  health,  shall  be  temperate,  able-bodied, 
cleanly  in  person,  not  addicted  to  drugs,  and  of  good  moral 
character,  and  no  others  shall  be  appointed.  School  physicians 
may  be  discharged  by  the  appointing  power  at  any  time  for 
written  cause.  School  physicians  shall  serve  one  year  and  until 
their  successors  are  appointed,  and  shall  receive  such  compensa- 
tion as  the  appointing  trustee  or  trustees  may  determine:  Pro- 
vided, The  compensation  shall  be  not  less  than  $5.00  for  each 
school  month  in  the  year. 


29 

Sec.  4.  School  physicians  shall  make  prompt  examination  and 
diagnosis  of  all  children  referred  to  them  and  such  further  ex- 
amination of  teachers,  janitors  and  school  buildings  as  in  their 
opinion  the  protection  of  the  health  of  the  pupils  and  teachers 
may  require.  Whenever  a  school  child  is  found  to  be  ill  or  suffer- 
ing from  any  physical  defect,  the  school  physician  shall  promptly 
send  it  home,  with  a  note  to  parents  or  guardians,  briefly  setting 
forth  the  discovered  facts,  and  advising  that  the  family  physician 
be  consulted.  If  the  parents  or  guardians  are  so  poor  as  to  be 
unable  to  give  the  relief  that  is  necessary,  then  school  trustees 
and  township  trustees,  as  the  case  may  be,  shall  provide  the 
necessary  relief:  Provided,  That  in  cities  where  public  dispen-- 
saries  exist,  the  relief  shall  be  given  by  said  dispensaries. 

School  physicians  shall  keep  accurate  card-index  records  of  all 
examinations,  and  said  records,  that  they  may  be  uniform  through- 
out the  state,  shall  be  according  to  the  form  prescribed  by  the 
rules  authorized  in  this  act,  and  the  method  and  manner  of  re- 
ports to  be  made  shall  be  accordmg  to  said  rules. 

Sec.  5.  The  State  board  of  education  and  the  state  board  of 
health  shall  jointly  pass  rules  for  the  detail  enforcement  of  the 
purposes  of  this  act,  which  rules  shall  bear  the  printed  seals  of 
said  boards;  the  said  rules  to  be  printed  and  promulgated  by  the 
state  printing  board;  promulgation  to  consist  in  supplying  a 
reasonable  number  of  copies  to  each  county  superintendent  from 
whom  all  who  are  interested  may  procure  a  copy.  Any  violation 
of  said  rules  shall  be  punished  by  a  fine  of  not  less  than  five  nor 
more  than  twenty-five  dollars. 

Sec.  6.  All  violations  of  this  act,  except  as  otherwise  provided, 
shall  be  punished  by  a  fine  of  not  less  than  ten  nor  more  than 
fifty  dollars. 

Sec.  7.  All  acts  in  conflict  with  this  act  are  repealed. 


30 


Louisiana 

Sanitary  Rkgulations  ok  the  Louisiana  State  Board  of 
Hk.\lth,    Concerning    Hygiene    and    Sanitation    of 

Schools 

[Adopted  191 1] 
SANITARY  CODE,  STATE  OF  LOUISIANA,  SECTION  250— 

(a)  The  parish  or  municipal  school  board,  and  parish  superin- 
tendent of  schools,  shall  be  held  responsible  for  the  execution  and 
enforcement  of  the  following  rules  and  regulations,  and  all  other 
health  laws  governing  the  hygiene  of  the  schoolroom  and  the 
premises  of  the  schools  under  their  respective  jurisdictions. 

(b)  Plans  and  specifications  for  every  schoolhouse  hereafter 
erected  in  the  State  must  be  submitted  to  the  parish  superinten- 
dent of  schools,  and  to  the  State  Superintendent  of  Education, 
and  also  to  the  parish  health  ofificer,  that  it  may  be  determined 
whether  every  hygienic  or  necessary  provision  is  made,  especially 
with  reference  to  ventilation,  light  and  protection  against  fire. 

(c)  Every  schoolhouse,  public  or  private,  or  other  building 
used  for  school  purposes,  shall  be  ventilated  in  such  manner  as 
to  afford  eighteen  hundred  cubic  feet  of  air  per  hour  for  each 
adult,  and  a  proportionate  amount  for  each  child,  and  shall  con- 
tain not  less  than  two  hundred  cubic  feet  of  air  space  for  each 
child  to  be  taught  therein.  Windows  and  transoms  shall  be  so 
constructed  that  windows  may  be  lowered  from  the  top  and 
transoms  opened.  Every  schoolhouse  must  be  lighted  in  such 
a  manner  as  to  minimize  the  eye  strain.  Each  room  must  con- 
tain of  actual  surface  of  glass  in  the  windows  not  less  than  one- 
seventh  of  the  floor  space. 

(d)  All  doors  except  those  which  slide  into  wall  pockets  shall 
open  outward,  and  all  partition  doors  shall  be  hung  on  double- 
action  hinges. 

(e)  The  floors  of  every  school  must  be  treated  w^ith  some 
antiseptic  floor  dressing.  Applications  to  be  at  sufficiently 
frequent  intervals  to  keep  down  effectually  the  dust;  floors  to 
be  scrubbed  thoroughly  before  each  application.  Floor  dress- 
ings for  use  in  the  schools  must  be  approved  by  the  State  analyst. 

The  floors  of  every  school  must  be  swept  daily,  sweeping  to 
be  done  after  all  pupils  have  left  the  building.     All  windows 


31 

must  be  thrown  open  and  schoolhouse  thoroughly  aired  after 
cleaning. 

AH  desks,  wainscoting,  window  sills  and  baseboards  in  every 
schoolhouse  in  the  State  must  be  wiped  off  daily  with  a  cloth 
moistened  with  1-2000  bichloride  of  mercury,  or  3  per  cent. 
carbolic  acid  solution. 

(f)  Spitting  on  the  floors,  walls,  etc.,  must  be  strictly  prohib- 
ited and  anti-spitting  placards  placed  in  every  room. 

(g)  No  person  suffering  from  any  communicable  disease  shall 
be  employed  as  teacher  or  janitor  in  any  public  school  in  this 
State.  At  the  opening  of  each  annual  term  teachers  must  furnish 
a  health  certificate  from  a  registered  physician,  addressed  to  the 
parish  superintendent  of  schools,  certifying  that  they  are  not 
suffering  from  tuberculosis  or  other  communicable  disease. 

No  one  shall  be  entered  as  a  pupil  in  the  public  schools  of 
this  State  without  first  having  presented  to  the  principal  in 
charge  a  certificate  from  a  registered  physician  of  Louisiana, 
certifying  that  within  the  preceding  five  years  the  applicant 
was  successfully  vaccinated. 

Three  unsuccessful  attempts  at  vaccination  with  a  proven 
virus  shall  be  accepted  as  an  immunity  for  a  period  of  one  year. 

Pupils  are  required,  at  the  end  of  each  five  years,  to  renew 
their  vaccination  certificates. 

(h)  No  pupil  suffering  from  any  communicable  disease  shall 
be  permitted  to  attend  the  public  schools  of  this  State.  The 
principal  or  the  teacher  has  the  right  to  exclude  any  child  from 
the  schools  whom  they  suspect  of  suffering  from  any  communi- 
cable disease,  pending  examination  and  report  of  a  registered 
physician. 

(i)  All  schoolrooms  in  the  State  must  be  disinfected  before 
the  beginning  of  each  school  session,  with  the  formaldehyde- 
permanganate  of  potash  mixture  as  indicated  in  the  bulletin  of 
disinfection. 

(j)  On  the  appearance  in  a  school  of  any  communicable  disease, 
either  among  the  pupils,  teachers  or  attendants,  the  school 
shall  be  closed  immediately  and  fumigated  before  re-opening. 

(k)  The  school  premises  shall  be  thoroughly  drained  and 
no  stagnant  water  permitted  to  collect.  In  towns  with  a  drain- 
age system,  or  where  an  outflow  is  possible,  the  school  site  and 
the  entire  area  of  the  ground  shall  be  properly  drained,  so  as  to 
reduce  the  ground  water  level,  and  the  drainage  effected  in  such 


32 

luaniuT  as  not  to  containinali'  with  its  t'ftlu\ia  any  well,  cistern 
or  otlur  soiHvo  of  drinkinjj  water. 

(1)  Mvcry  school  must  be  supplied  with  an  abundance  of 
pure  drinking  water  for  drinking  {purposes.  Where  water  is 
used  from  surface  wells,  said  wells  must  be  located  at  least  lOO 
feet  from  any  closet. 

(m)  The  use  of  open  receptacles  for  drinking  water  in  schools, 
and  also  of  dippers  or  cups  for  common  drinking  purposes,  is 
prohibited.  The  school  authorities  must  supply  for  holding 
drinking  water  covered  containers  with  faucets,  which  con- 
tainers must  be  scoured  daily  when  in  use.  All  teachers  and 
pupils  must  provide  themselves  with  individual  drinking  cups 
or  glasses.  In  towns  or  cities  where  there  is  a  public  water 
supply  a  sanitary  drinking  fountain  shall  be  installed. 

(n)  Every  school  in  this  State  must  have  a  sufficient  number 
of  trash  or  garbage  cans  for  the  convenience  of  the  pupils, 
teachers  and  employees,  and  said  trash  or  garbage  cans  must 
be  kept  closed,  and  emptied  daily. 

(o)  The  urinals  and  water  closets  must  be  connected  with 
the  sewerage  system,  where  one  exists,  when  within  looo  feet 
therefrom.  Where  no  sewerage  system  exists,  all  schools 
must  have  a  Stiles  sanitary  closet  (plans  and  specifications  will 
be  furnished  by  the  State  Board  of  Health  upon  request),  cess- 
pool or  septic  tank.  Where  the  Stiles  sanitary  closet  is  used 
the  inner  surface  of  the  container  must  be  treated  with  crude 
petroleum  at  least  once  a  week.  All  closets  must  be  scrubbed 
once  a  week  and  kept  in  a  sanitary  condition  at  all  times. 

(p)  The  State  Board  of  Health  will,  when  desired  by  the 
State  institutions  of  learning,  or  the  State  Pedagogical  Insti- 
tutes, or  the  Agricultural  Institutes,  send  a  lecturer  to  deliver 
a  series  of  lectures  on: 

1.  Personal  hygiene. 

2.  School  hygiene. 

3.  Principles  and  practice  of  physical  training. 

4.  Drug  and  alcohol  addictions. 

5.  Contagious  and  infectious  diseases;   cause  and  prevention. 

6.  Hygiene  of  the  home  and  farm. 

(q)  The  principal  of  each  school  in  the  State,  except  in  cities 
where  there  is  employed  a  regular  medical  inspector,  shall  make 
a  monthly  report  to  the  parish  superintendent  of  schools  on  the 
sanitary  condition  of  the  school  building  and  surroundings,  also 


33 

the  physical  condition  of  the  school  children.  Blank  reports 
for  this  purpose  will  be  furnished  by  the  Louisiana  State  Board 
of  Health.  Parish  superintendents  of  schools  shall  forward 
these  reports  to  the  Louisiana  State  Board  of  Health  within  ten 
days  after  their  receipt  by  him. 


Maine 

An  Act  Relative  to  the  Appointment  of  School  Physicians 

(Chap.  73,  P.  L.  1909) 
[Approved  March   16,   1909] 
Section  i  .  The  school  committee  of  every  city  and  town  shall  school 

,         ,        ,         .    .  1       1      11  •  physicians,    ap- 

appomt  one  or  more  school  physicians  and  shall  assign  one  to  pointment  of.i 

the  medical  inspection  of  not  over  one  thousand  pupils  of  the 

public  schools  within  its  city  or  town,  and  shall  provide  them 

with   all   proper  facilities   for   the   performance  of   their  duties 

as  prescribed  in  this  act,  provided,  however,  the  said  committee 

has  been  so  authorized  by  vote  of  town  at  regular  town  meeting 

or  at  a  special  town  meeting  called  for  that  purpose. 

Sec.  2.  Every  school  physician  shall  make  a  prompt  exami-  ^h'^ifdan 
nation  and  diagnosis  of  all  children  referred  to  him  as  herein- 
after provided,  and  such  further  examination  of  teachers,  jani- 
tors and  school  buildings  as  in  his  opinion  the  protection  of  the 
health  of  the  pupils  may  require. 

Sec.  3.  The  pupils  so  examined  by  school  physicians  when  Pupils,  by 
treatment  is  necessary  shall  not  be  referred  to  the  school  phy- 
sicians for  such  treatment  except  the  school  physician  be  the 
regular  family  physician  of  such  pupil,  but  shall  be  referred  to 
the  regular  family  physician  of  such  pupil  through  the  parents 
or  guardian. 

Sec.  4.  The  school  committee  shall  cause  to  be  referred  to  Examination  of 
a  school  physician  for  examination  and  diagnosis  every  child  absence  on 
returning  to  a  school  without  a  certificate  from  the  board  of  sickness. 
health  or  family  physician  after  absence  on  account  of  illness  or 
from  unknown  cause;    and  every  child  in  the  schools  under  its 
jurisdiction  who  shows  signs  of  being  in  ill  health  or  of  suffer- 
ing from  infectious  or  contagious  diseases,  unless  he  is  at  once 
excluded  from  school  by  the  teacher;    except  that  in  case  of  —L-xception 
3 


34 


NotKc    •■! 
(liaruae  or 


Examination  of 
sisht    and 

(•.-..ririL'. 


— notice  to 
parent  or 
Kuardian. 


State    super- 
intendent   of 
schools    shall 
I)rescribe  direc- 
tions   for    tests 
of     sight     and 
hearing. 

— amount  to  be 
expended. 


Expense      that 
may    be    in- 
curred   by   city 
or  loan. 


schools  in  remote  ami  isolated  situations,  the  school  committee 
may  make  such  other  arrangements  as  may  best  carry  out  the 
pur[H)ses  of  this  act. 

Si-:c.  5.  The  school  committee  shall  cause  notice  of  disease 
or  defects,  if  any,  from  which  any  child  is  found  to  be  sufTer- 
iiii;  to  be  sent  home  to  his  parents  or  guardian.  Whenever  a 
child  shows  symptoms  of  smallpox,  scarlet  fever,  measles, 
chicken  pox,  tuberculosis,  diphtheria  or  influenza,  tonsilitis, 
whooping  cough,  mumps,  scabies  or  trachoma,  he  shall  be  sent 
home  immediately  or  as  soon  as  safe  and  proper  conveyance  can 
be  found,  and  the  board  of  health  and  superintendent  of  schools 
shall  at  once  be  notified. 

Sec.  6.  The  school  committee  of  every  city  or  town  shall 
cause  every  child  in  the  public  schools  to  be  separately  and  care- 
fully tested  and  examined  at  least  once  in  every  school  year  to 
ascertain  whether  he  is  suffering  from  defective  sight  or  hear- 
ing or  from  any  other  disability  or  defect  tending  to  prevent 
his  receiving  the  full  benefit  of  his  school  work,  or  requiring  a 
modification  of  the  school  work  in  order  to  prevent  injury  to 
the  child  or  to  secure  the  best  educational  results.  Tests  of 
sight  and  hearing  shall  be  made  by  the  teachers  or  by  the  school 
physicians.  The  committee  shall  cause  notice  of  any  defect  or 
disability  requiring  treatment  to  be  sent  to  the  parent  or  guar- 
dian of  the  child,  and  shall  require  a  physical  record  of  each 
child  to  be  kept  in  such  form  as  the  state  superintendent  of 
public  schools  shall  prescribe  after  consultation  with  the  state 
board  of  health. 

Sec.  7.  The  state  superintendent  of  public  schools  shall  pre- 
scribe after  consultation  with  the  state  board  of  health  the 
directions  for  tests  of  sight  and  hearing,  and  shall  prescribe  and 
furnish  to  the  school  committees  suitable  rules  of  instruction, 
test  cards,  blanks,  record  books  and  other  useful  appliances  for 
carrying  out  the  purposes  of  this  act.  The  state  superintendent 
of  public  schools  may  expend  during  the  year  nineteen  hundred 
and  nine  a  sum  not  greater  than  five  hundred  dollars  for  the 
purpose  of  supplying  the  material  required  for  this  act. 

Sec.  8.  Expenses  which  a  city  or  town  may  incur  by  virtue 
of  the  authority  herein  vested  in  the  school  committee  shall  not 
exceed  the  amount  appropriated  for  that  purpose  in  cities  by 
the  city  council  and  in  towns  by  a  town  meeting.  The  appro- 
priation  shall    precede   any   expenditure   of   any   indebtedness 


35 

which  may  be  incurred  under  this  act  and  the  sum  appropriated 
shall  be  deemed  sufficient  appropriation  in  the  municipality 
where  it  is  made.  Such  appropriation  need  not  specify  to  what 
section  of  the  act  it  shall  apply  and  may  be  voted  as  a  total 
appropriation  to  be  applied  in  carrying  out  the  purposes  of  this 
act. 

Sec.  9.  The  provision  of  this  act  shall  apply  only  to  cities  ^fjes^^nd 
and   towns   having  a   population   of   less   than   forty   thousand  fes^"than*^1orty 
inhabitants.  I'^JIf^t.  '" 


Massachusetts 

(Chapter  502,  Acts  of  1906) 

APPOINTMENT  OF  SCHOOL  PHYSICIANS,  ETC. 
Section  i.  (As  amended  by  chapter  257,  Acts  oj  igio.)  The 
school  committee  of  every  city  and  town  in  the  Commonwealth 
shall  appoint  one  or  more  school  physicians,  shall  assign  one  to 
each  public  school  within  its  city  or  town,  and  shall  pro\nde 
them  with  all  proper  facilities  for  the  performance  of  their  duties 
as  prescribed  in  this  act;  and  shall  assign  one  or  more  to  perform 
the  duty  of  examining  children  who  apply  for  health  certificates  in 
accordance  with  this  act:  provided,  however,  that  in  cities  wherein 
the  board  of  health  is  already  maintaining  or  shall  hereafter 
maintain  substantially  such  medical  inspection  as  this  act 
requires,  the  board  of  health  shall  appoint  and  assign  the  school 
physician. 

EXAMINATION  AND  DIAGNOSIS  TO  BE  MADE 
Sec.  2.  {As  amended  by  chapter  2^7,  Acts  of  iqio.)  Every 
school  physician  shall  make  a  prompt  examination  and  diagnosis 
of  all  children  referred  to  him  as  hereinafter  provided,  and  such 
further  examination  of  teachers,  janitors  and  school  buildings  as 
in  his  opinion  the  protection  of  the  health  of  the  pupils  may  re- 
ciuire.  Every  school  physician  who  is  assigned  to  perform  the 
duty  of  examining  children  who  apply  for  health  certificates  shall 
make  a  prompt  examination  of  every  child  who  wishes  to  obtain 
an  age  and  schooling  certificate,  as  provided  in  section  sixty  of 
chapter  five  hundred  and  fourteen  of  the  acts  of  the  year  nineteen 
hundred  and  nine,  and  who  presents  to  said  physiciati  an  employ- 


36 

metit  tiik'ft,  as  jiroNidcd  in  said  section,  and  the  physician  shall 
certify  in  writing  whether  or  not  in  his  opinion  such  child  is  in 
sufficiently  sound  health  and  physically  able  to  perform  the  work 
which  the  child  intends  to  do. 

MTHORITV  OF  SCHOOL  COMMITTEES,  ETC. 
Si-:c.  3.  The  school  committee  shall  cause  to  be  referred  to  a 
school  physician  for  examination  and  diagnosis  every  child 
returning  to  school  without  a  certificate  from  the  board  of  health 
after  absence  on  account  of  illness  or  from  unknown  cause;  and 
every  child  in  the  schools  under  its  jurisdiction  who  shows  signs 
of  being  in  ill  health  or  of  suffering  from  infectious  or  contagious 
disease,  unless  he  is  at  once  excluded  from  school  by  the  teacher; 
except  that  in  the  case  of  schools  in  remote  and  isolated  situations 
the  school  committee  may  make  such  other  arrangements  as 
may  best  carr>-  out  the  purposes  of  this  act. 

NOTICE  TO  BE  SENT  TO  PARENT  OR  GUARDIAN 
Sec.  4.  The  school  committee  shall  cause  notice  of  the  disease 
or  defects,  if  any,  from  which  any  child  is  found  to  be  suffering 
to  be  sent  to  his  parents  or  guardian.  Whenever  a  child  shows 
symptoms  of  smallpox,  scarlet  fever,  measles,  chickenpox, 
tuberculosis,  diphtheria  or  influenza,  tonsilitis,  whooping  cough, 
mumps,  scabies  or  trachoma,  he  shall  be  sent  home  immediately, 
or  as  soon  as  safe  and  proper  conveyance  can  be  found,  and  the 
board  of  health  shall  at  once  be  notified. 

TESTS  OF  SIGHT  AND  HEARING,  AND  EXAMINATION  FOR  DIS- 
ABILITY OR  DEFECTS 

Sec.  5.  The  school  committee  of  every  city  and  town  shall 
cause  every  child  in  the  public  schools  to  be  separately  and  care- 
fully tested  and  examined  at  least  once  in  every  school  year  to 
ascertain  whether  he  is  suffering  from  defective  sight  or  hearing 
or  from  any  other  disability  or  defect  tending  to  prevent  his 
receiving  the  full  benefit  of  his  school  work,  or  requiring  a  modi- 
fication of  the  school  work  in  order  to  prevent  injury  to  the  child 
or  to  secure  the  best  educational  results.  The  tests  of  sight  and 
hearing  shall  be  made  by  teachers.  The  committee  shall  cause 
notice  of  any  defect  or  disability  requiring  treatment  to  be  sent 
to  the  parents  or  guardian  of  the  child,  and  shall  require  a  physical 
record  of  each  child  to  be  kept  in  such  form  as  the  state  board  of 
education  shall  prescribe. 


37 

STATE  BOARD  OF  HEALTH  TO  PRESCRIBE  DIRECTIONS;   STATE 
BOARD  OF  EDUCATION  TO  FURNISH  RULES,  ETC. 

Sec.  6.  The  state  board  of  health  shall  prescribe  the  directions 
for  tests  of  sight  and  hearing  and  the  state  board  of  education 
shall,  after  consultation  with  the  state  board  of  health,  prescribe 
and  furnish  to  school  committees,  suitable  rules  of  instruction, 
test-cards,  blanks,  record  books  and  other  useful  appliances  for 
carrying  out  the  purposes  of  this  act,  and  shall  provide  for 
pupils  in  the  normal  schools  instruction  and  practice  in  the  best 
methods  of  testing  the  sight  and  hearing  of  children.  The  state 
board  of  education  may  expend  during  the  year  nineteen  hundred 
and  six  a  sum  not  greater  than  fifteen  hundred  dollars,  and  annu- 
ally thereafter  a  sum  not  greater  than  five  hundred  dollars* 
for  the  purpose  of  supplying  the  material  required  by  this  act. 

CHAPTER  257,  ACTS  OF  1910 

Sections  i  and  2  of  chapter  257  amend  sections  i  and  2  of 
chapter  502,  Acts  of  1906,  as  given  above. 

Section  3  of  chapter  257  amends  section  58  of  chapter  514, 
Acts  of  1909,  as  given  below. 

An  age  and  schooling  certificate  shall  be  approved  only  by  the 
superintendent  of  schools  or  by  a  person  authorized  by  him  in 
writing,  or,  if  there  is  no  superintendent  of  schools,  by  a  person 
authorized  by  the  school  committee;  but  no  member  of  a  school 
committee  or  other  person  authorized  as  aforesaid  shall  approve 
such  certificate  for  any  minor  then  in  or  about  to  enter  his  own 
employment  or  the  employment  of  a  firm  or  corporation  of  which 
he  is  a  member,  officer  or  employee.  No  such  certificate  shall 
be  approved  by  any  person  unless  he  is  satisfied  that  the  minor 
therein  named  is  able  to  read  at  sight  and  to  write  legibly  simple 
sentences  in  the  English  language,  nor  until  such  person  has 
received  a  certificate  signed  by  a  physician,  as  provided  in  chapter 
five  hundred  and  two  of  the  acts  of  the  year  nineteen  hundred  and 
six  and  acts  passed  in  amendment  thereof,  or  by  a  physician  ap- 
pointed by  the  school  committee,  stating  that  said  minor  has  been 
examined  by  him  and  in  his  opinion  is  in  sufficiently  sound  health 
and  physically  able  to  perform  the  work  which  the  minor  intends 
to  do;  provided,  however,  that  the  age  and  schooling  certificate  may 
be  approved  and  issued  without  a  physician  s  certificate  if  there 
shall  be  on  file  in  connection  with  the  public  schools  a  written  record 

*  Eight  hundred  dollars  now  appropriated  under  chapter  189,  Acts  of  1908. 


3« 

in  rfiiard  to  the  liiiUi's  physical  conditio)!  made  within  one  year  and 
th(  person  authorized  to  approve  said  age  and  schooling  certificate 
after  having  examined  such  record  shall  certify  that  in  his  opinion 
said  minor  is  in  sufficiently  sound  health  and  physically  able  to 
perform  the  work  which  the  tninor  intends  to  do.  The  person 
wlio  appro\cs  the  certificate  may  administer  the  oath  provided 
for  therein,  Init  no  fee  shall  be  charged  therefor. 

Section  4  of  chapter  257,  Acts  of  1910,  amends,  as  given 
below,  section  60,  Acts  of  1909. 

EMPLOYMENT  TICKET  AND  AGE  AND  SCHOOLING  CERTIFICATE 
The  age  and  schooling  certificate  of  a  minor  under  sixteen 
years  of  age  shall  not  be  approved  and  signed  until  he  presents  to 
the  person  who  is  authorized  to  approve  and  sign  it  an  employ- 
ment ticket  duly  filled  out  and  signed.  A  duplicate  of  each  age 
and  schooling  certificate  shall  be  filled  out  and  shall  be  kept  on 
file  by  the  school  committee.  Any  explanatory  matter  may,  in 
the  discretion  of  the  school  committee  or  superintendent  of 
schools,  be  printed  with  such  certificate.  The  employment 
ticket  and  the  age  and  schooling  certificate  shall  be  separately 
printed  and  shall  be  filled  out,  signed  and  held  or  surrendered 
as  indicated  in  the  following  forms: — 

EMPLOYMENT  TICKET,  ST.  1909,  C.  514,,  §60 
When    [name   of    minor]  ,    height    [feet   and    inches] 

,  complexion  [fair  or  dark]  ,  hair  [color] 

presents  an  age  and  schooling  certificate  duly  signed,  I  intend  to 
employ  [him  or  her]. 

(Signature  of  intending  employer  or  agent.)  (Town  or  city 
and  date.) 

AGE  AND   SCHOOLING   CERTIFICATE,  ST.  1909,  C.  514,  §60,    AS 
AMENDED  BY  ST.  1910,  C.  257,   §4 

This  certifies  that  I  am  the  [father,  mother,  guardian  or 
custodian]  of  [name  of  minor],  and  that  [he  or  she]  was  born 
at  [name  of  city  or  town],  in  the  county  of  [name  of  county,  if 
known],  and  state  [or  country]  of  ,  on  the  [day  and  year 

of  birth],  and  is  now  [number  of  years  and  months]  old. 

[Signature  of  father,  mother,  guardian  or  custodian.] 

[City  or  town  and  date.] 

Then  personally  appeared  before  me  the  above-named  [name 


39 

of  person  signing],  and  made  oath  that  the  foregoing  certificate 
by  [him  or  her]  signed  is  true  to  the  best  of  [his  or  her]  knowledge 
and  belief.  I  hereby  approve  the  foregoing  certificate  of  [name 
of  minor],  height  [feet  and  inches],  complexion  [fair  or  dark], 
hair  [color],  having  no  sufficient  reason  to  doubt  that  [he  or  she] 
is  of  the  age  herein  certified.  I  hereby  certify  and  am  satisfied 
that  [he  or  she]  can  read  at  sight  and  can  write  legibly  simple 
sentences  in  the  English  language.  I  further  certify  that  in 
my  opinion  [or  in  the  opinion  of  ,  the  physician 

by  whom  said  minor  has  been  examined  in  accordance  with 
section  fifty-eight  of  the  above  chapter]  he  [or  she]  is  in  sufficiently 
sound  health  and  physically  able  to  perform  the  work  which  he 
[or  she]  intends  to  do. 

This  certificate  belongs  to  [name  of  minor  in  whose  behalf  it 
is  drawn],  and  is  to  be  surrendered  to  [him  or  her]  whenever 
[he  or  she]  leaves  the  service  of  the  corporation  or  employer 
holding  the  same;  but  if  not  claimed  by  said  minor  within  thirty 
days  after  such  time,  it  shall  be  returned  to  the  superintendent 
of  schools,  or,  if  there  is  no  superintendent  of  schools,  to  the  school 
committee. 

[Signature  of  person  authorized  to  approve  and  sign, 
with  official  character  or  authority.] 

[City  or  town  and  date.] 

In  the  case  of  a  minor  who  cannot  read  at  sight  and  write 
legibly  simple  sentences  in  the  English  language,  the  certificate 
shall  continue  as  follows,  after  the  word  "language": — 

I  hereby  certify  that  [he  or  she]  is  regularly  attending  the 
[name]  public    evening    school.     This    certificate 

shall  continue  in  force  only  so  long  as  the  regular  attendance 
of  said  minor  at  the  evening  school  is  endorsed  weekly  by  a 
teacher  thereof. 

This  act  shall  take  effect  on  the  first  day  of  August  in  the  year 
nineteen  hundred  and  ten. 


40 


Minnesota 

Re(.ulations  of  the  Minnesota  State  Board  of   Health 

(Adopted  June  15,  1910] 
PROTECTINC,  THE  HEALTH  OF  SCHOOL  CHILDREN 

71.  The  local  board  of  health  of  every  city,  village  and  town- 
ship in  Minnesota  shall  appoint  one  or  more  school  physicians, 
shall  assign  a  school  physician  to  every  school  within  the  city, 
village  or  township,  shall  provide  him  with  all  necessary  blanks 
and  proper  facilities  for  the  performance  of  his  duties  and  shall 
rcciuirc  him  to  call  at  such  intervals  as  may  be  prescribed  by  the 
local  board  of  health,  or  whenever  notified  so  to  do  by  the  head 
of  the  school,  at  the  school  building  or  buildings  under  his  juris- 
diction; except  that,  in  the  case  of  schools  in  remote  and  isolated 
situations,  the  local  board  of  health  ma}-,  after  consultation  with 
the  State  Board  of  Health,  make  such  other  arrangement  as 
may  best  carry  out  the  purpose  of  this  regulation. 

72.  Each  school  physician  shall  make  a  medical  examination 
of  all  school  children  referred  to  him  for  that  purpose,  and  such 
examination  of  pupils,  teachers  and  janitors,  and  of  school 
buildings  as  in  his  opinion  the  protection  of  the  health  of  the 
public  may  require,  and  shall  report  the  results  of  such  examina- 
tions to  the  State  Board  of  Health. 

73.  The  local  board  of  health  of  every  city  and  village  shall 
require  every  teacher  to  report  each  morning  to  the  head  of  the 
school  the  case  of  every  child  belonging  to  his  or  her  room  who 
shows  signs  of  being  in  ill  health  or  suffering  from  a  communicable 
disease;  also  every  child  returning  to  school  after  absence  on 
account  of  illness  of  unknown  cause.  The  head  of  the  school, 
upon  receiving  such  report,  shall  as  soon  as  possible  thereafter 
notify  the  school  physician  and  refer  to  him  all  such  cases  for 
examination.  Whenever,  in  the  opinion  of  the  head  of  the  school, 
a  child's  condition  requires  that  he  or  she  be  sent  home,  and 
whenever  a  child  shows  symptoms  of  smallpox,  scarlet  fever, 
diphtheria,  measles,  chicken  pox,  tuberculosis,  influenza,  tonsili- 
tis,  erysipelas,  whooping  cough,  mumps,  itch,  ringworm  or 
trachoma,  he  or  she  shall  send  such  suspect  home  immediately, 
or  as  soon  as  a  safe  and  proper  conveyance  can  be  found,  and  the 
local  health  officer  shall  be  notified  at  once  by  the  head  of  the 
school  of  such  case. 


41 

74-  In  the  event  of  any  school  child  having  smallpox,  or  having 
been  exposed  to  the  disease  while  in  attendance  at  school,  the 
building  where  such  child  is  in  attendance  shall  be  closed  by  the 
order  of  the  local  health  officer  and  kept  closed  until  the  place 
has  been  thoroughly  disinfected  and  cleansed  under  the  super- 
vision of  said  health  officer. 

In  the  event  of  the  Board  of  Education  having  passed  a  regula- 
tion requiring  vaccination  of  all  teachers  and  pupils,  the  school 
may  be  opened  after  the  above  disinfection  and  cleansing; 
otherwise  the  school  shall  be  kept  closed  until  the  local  board  of 
health,  with  the  approval  of  the  State  Board  of  Health,  directs 
otherwise. 

75.  No  principal,  superintendent  or  teacher  of  any  school,  and 
no  parent,  master  or  guardian  of  any  child  or  minor,  having  the 
power  and  authority  to  prevent,  shall  permit  any  such  child  or 
minor  having  small-pox,  scarlet  fever,  diphtheria,  measles,  chicken- 
pox,  tuberculosis,  influenza,  tonsilitis,  erysipelas,  whooping  cough, 
mumps,  itch,  ringworm  or  trachoma,  or  any  other  dangerous 
communicable  disease,  or  any  child  residing  in  any  house  in  which 
any  such  disease  exists  or  has  recently  existed,  to  attend  any 
public,  private,  parochial,  church  or  Sunday  school  until  tlie 
local  health  officer  of  the  city,  village  or  township  shall  have 
given  his  permission  for  such  attendance. 

76.  A  school  house  wherein  a  child  suffering  from  scarlet  fever 
or  diphtheria  has  been  present  shall  be  deemed  infected  and  must 
be  temporarily  closed  and  thoroughly  disinfected  and  cleaned 
under  the  supervision  of  the  local  health  officer  before  the  re- 
opening of  the  school.  Such  disinfection  and  cleaning  shall  be 
done  according  to  the  direction  of  the  Minnesota  State  Board  of 
Health  in  its  circular  on  disinfection. 

77.  All  school  houses  shall  be  inspected  from  time  to  time  by 
the  local  health  officer,  and  if  found  to  be  in  an  unclean  or 
unsanitary  condition,  said  health  officer  shall  forthwith  order 
that  the  place  be  closed  and  kept  closed  until  it  has  been  properly 
cleaned  or  disinfected,  or  both,  as  the  case  may  require. 

78.  The  local  board  of  health  of  every  city  and  village  shall 
cause  every  child  in  the  public  schools  to  be  separately  and 
carefully  tested  and  examined  at  least  once  in  every  school  year 
in  order  to  ascertain  whether  he  or  she  is  suffering  from  defective 
sight  or  hearing,  or  from  any  other  disability  tending  to  prevent 
his  or  her  receiving  the  full  benefit  of  the  school  work,  or  requiring 


42  / 

a  nuxliticatioii  of  the  school  work  in  order  to  prev^ent  injury  to 
the  child  or  to  secure  the  best  educational  results  for  such  child. 
Tests  of  siiiht  and  hearini;  shall  be  made  by  teachers  and  reported 
to  ilie  Minnesota  State  Board  of  Health  by  the  head  of  the  school. 
The  heat!  of  the  school  shall  cause  notice  of  any  defect  or  disa- 
bility in  any  child  requiring  treatment  to  be  sent  to  the  parent 
or  guardian  of  the  child. 

79.  The  Minnesota  State  Board  of  Health  shall  prescribe 
and  furnish  to  the  superintendents  of  schools  suitable  rules  of 
instructions,  test  cards,  blanks,  records  and  other  appliances  for 
carrying  out  the  above  regulations.  The  several  Normal 
Boards  of  the  state  shall  provide  for  pupils  in  the  Normal  Schools 
the  instruction  and  practice  prescribed  by  the  State  Board  of 
Health  for  testing  the  sight  and  hearing  of  school  children. 


New  Jersey 
Chapter  92,  P.  L.  1909 — Relating  to  Medical  Inspection 

[Approved  April  13,  1909] 

229.  Every  board  of  education  shall  employ  a  competent 
physician  to  be  known  as  the  medical  inspector  and  fix  his  salary 
and  term  of  office.  Every  board  of  education  shall  adopt  rules 
for  the  government  of  the  medical  inspector,  which  rules  shall 
be  submitted  to  the  State  Board  of  Education  for  approval. 

The  medical  inspector  shall  examine  every  pupil  to  learn 
whether  any  physical  defect  exists,  and  keep  a  record  from  year 
to  year  of  the  growth  and  development  of  such  pupil,  which 
record  shall  be  the  property  of  the  board  of  education,  and 
shall  be  delivered  by  said  medical  inspector  to  his  successor  in 
office.  Said  inspector  shall  lecture  before  the  teachers  at  such 
times  as  may  be  designated  by  the  board  of  education,  instructing 
them  concerning  the  methods  employed  to  detect  the  first  signs 
of  communicable  disease  and  the  recognized  measures  for  the 
promotion  of  health  and  the  prevention  of  disease.  The  board 
of  education  may  appoint  more  than  one  medical  inspector.  A 
board  of  education  may  exclude  from  school  any  child  whose 
presence  in  the  school-room  shall  be  certified  by  the  medical 
inspector  as  detrimental  to  the  health  or  cleanliness  of  the  pupils 


43 

in  the  school,  and  shall  notify  the  parent,  guardian  or  other 
person  having  control  of  such  child  of  the  reason  therefor.  If 
the  cause  for  exclusion  is  such  that  it  can  be  remedied,  and  the 
parent,  guardian  or  other  person  having  control  of  the  child 
excluded  as  aforesaid  shall  fail  or  neglect  within  a  reasonable 
time  to  have  the  cause  for  such  exclusion  removed,  such  parent, 
guardian  or  other  person  shall  be  proceeded  against,  and,  upon 
conviction,  be  punishable  as  a  disorderly  person. 
This  act  shall  take  effect  immediately. 


New  York 

Chapter  602. — ^An  Act  to  Amend  the  Education  Law,  in 

Relation  to  the   Powers   and   Duties  of   Boards  of 

Education 

Became  a  law  June  23,  1910 

The  People  of  the  State  of  New  York,  represented  in  Senate  and 
Assembly,  do  enact  as  follows: 

Section  i.  Section  three  hundred  and  ten  of  chapter  twenty- 
one  of  the  laws  of  nineteen  hundred  and  nine,  entitled  "An  act 
relating  to  education,  constituting  chapter  sixteen  of  the  consoli- 
dated laws,"  as  amended  by  chapter  one  hundred  and  forty  of 
the  laws  of  nineteen  hundred  and  ten,  is  hereby  amended  by  adding 
thereto  a  new  subdivision,  to  be  known  as  subdivision  twenty- 
one,  and  to  read  as  follows: 

21.  To  provide  for  the  medical  inspection  of  all  children  in 
attendance  upon  schools  under  their  supervision  whenever  in 
their  judgment  such  inspection  shall  be  necessary  and  to  pay 
any  expense  incurred  therefor  out  of  funds  authorized  by  the 
voters  of  the  district  or  city  or  which  may  properly  be  set  aside 
for  such  purpose  by  the  common  council  or  the  board  of  esti- 
mate and  apportionment  of  a  city. 

Sec.  2.  This  act  shall  take  effect  immediately. 


44 

North  Dakota 

[Enacted  191 1] 

Section  238.  Medical  Inspection  of  Schools.  The  board 
of  any  school  corporation  may  employ  one  or  more  physicians 
as  meilical  inspector  of  schools.  It  shall  be  the  duty  of  the 
medical  inspector  to  examine,  at  least  once  annually,  all  children 
enrolled  in  the  public  schools  of  the  district,  except  those  who 
present  a  certificate  of  health  from  a  licensed  physician,  and  to 
make  out  suitable  records  for  each  child,  one  copy  of  which  shall 
bo  filed  with  the  county  or  city  superintendent  of  schools.  Notice 
of  physical  defects  of  abnormal  or  diseased  children  shall  be  sent 
to  the  parents,  with  recommendations  for  the  parent's  guidance 
in  conserving  the  child's  health.  The  medical  inspector  shall 
co-operate  with  state,  county  and  township  boards  of  health  in 
dealing  with  contagious  and  infectious  diseases  and  to  secure 
medical  treatment  for  indigent  children.  It  shall  be  the  duty 
of  the  county  and  city  superintendents  of  schools  to  co-operate 
with  school  boards  in  promoting  medical  inspection.  He  may 
arrange  schools  by  groups,  especially  in  the  rural  districts,  for 
purposes  of  inspection,  and  shall  advise  school  boards  with  a  view 
to  securing  the  most  efficient  and  economical  administrations  of 
this  law.  The  school  board  or  board  of  education  shall  furnish 
all  blanks  and  other  needed  supplies  for  this  purpose. 


Ohio 

[Enacted  1910] 

Medical  SECTION  7692.  Any  board  of  education  in  a  city  school  district 

may  provide  for  the  medical  inspection  of  pupils  attending  the 
public  schools.  For  that  purpose  it  can  employ  competent 
physicians,  nurses,  and  provide  for  and  pay  all  expenses  incident 
thereto  from  the  public  school  funds,  or  by  agreement  with  the 
board  of  health  or  other  board  or  officer  performing  the  functions 
of  a  board  of  health  for  such  city.  It  may  provide  for  medical 
and  sanitary  supervision  and  inspection  of  the  schools  which  are 
under  the  control  of  such  board  of  education  and  of  the  pupils 


45 

attending  such  schools,  by  a  competent  ph^^slcian  selected  by 
the  parent  or  guardian  of  the  child,  but  on  failure  of  the  parent 
or  guardian,  then  by  the  district  physicians  and  other  employes 
to  be  appointed  by  such  board  of  health.     (R.  S.  Sec.  4018a.) 

Sec.  7693.  A  board  of  education  in  a  city  school  district  mak-  Compensation 
ing  such  agreement  may  provide  and  pay  compensation  to  the 
employes  of  the  board  of  health  in  addition  to  that  provided  by 
the  city.     (R.  S.  Sec.  4018a.) 


Pennsylvania 

School  Code 

Article  XV 

MEDICAL  INSPECTION  AND  HYGIENE 

[Enacted  191 1] 

Section  1501.  Every  school  district  of  the  first  second  or 
third  class  in  this  Commonwealth  shall  annually  provide  medical 
inspection  of  all  the  pupils  of  its  public  schools  by  proper  medical 
inspectors  to  be  appointed  by  the  board  of  school  directors  of  the 
district.  Such  medical  inspection  shall  be  made  in  the  presence 
of  the  parent  or  guardian  of  the  pupil  when  so  requested  by 
parent  or  guardian.  All  such  medical  inspectors  shall  be  phy- 
sicians legally  qualified  to  practice  medicine  in  this  Common- 
wealth who  have  had  at  least  two  years'  experience  in  the  prac- 
tice of  their  profession  and  shall  be  paid  such  amounts  as  the 
boards  of  school  directors  may  determine.  Provided  that  noth- 
ing in  this  act  shall  preclude  the  appointment  of  health  officers 
of  municipalities  as  medical  inspectors  in  the  school  districts  of 
this  Commonwealth.  Provided  further  that  if  in  any  year  before 
the  first  day  of  August  the  board  of  school  directors  of  any  school  dis- 
trict of  the  third  class  shall  decide  by  a  majority  vote  of  the  members 
thereof  not  to  have  medical  inspection  in  any  or  all  of  the  schools 
of  such  district  such  medical  inspection  shall  not  be  made  in  such 
schools  during  the  following  school  year. 

Sec.  1502.  In  school  districts  of  the  first  class  wluTciii  tlie 
Department  or  Board  of  Health  therein  is  providing  llie  medical 


46 

ins|xx-ti<)ii  fi)r  tin-  public  t^chools  as  required  by  this  act  said  De- 
partment or  Board  of  Health  may  if  it  so  elects  continue  to  pro- 
\  ide  such  medical  inspection  and  appoint  such  number  of  in- 
spectors therefor  with  such  salaries  as  shall  be  satisfactory  to  the 
board  of  school  directors  of  the  district  and  the  medical  inspection 
so  provided  shall  be  deemed  a  compliance  with  this  act  and  shall 
l>c  paid  for  by  the  school  district. 

Sec.  1503.  In  every  school  district  of  the  fourth  class  in  this 
Commonwealth  the  State  Department  of  Health  shall  provide 
in  such  manner  as  it  may  determine  medical  inspection  for  all 
the  pupils  in  the  public  schools  by  proper  medical  inspectors 
to  be  appointed  by  the  State  Commissioner  of  Health  at  the 
expense  of  said  Department.  All  such  medical  inspectors  shall 
be  legally  qualified  physicians  who  have  had  not  less  than  two 
years'  experience  in  the  practice  of  their  profession.  Such 
medical  inspection  shall  be  made  in  the  presence  of  the  parent  or 
guardian  of  the  pupil  when  so  requested  by  parent  or  guardian. 
Provided  that  if  the  board  of  school  directors  of  any  school  district 
of  the  fourth  class  shall  decide  by  a  majority  vote  of  the  members 
thereof  not  to  have  medical  inspection  of  the  pupils  in  a  part  or  all 
of  the  schools  of  such  district  and  the  Commissioner  of  Health  is 
officially  notified  thereof  in  writing  before  the  first  day  of  July  such 
medical  inspection  shall  not  be  made  in  such  schools  during  the 
following  school  year. 

Sec.  1504.  If  in  any  school  district  which  is  required  by  this 
act  to  provide  medical  inspection  for  its  public  schools  such  medical 
inspection  as  is  herein  required  is  not  furnished  within  thirty  days 
after  the  beginning  of  the  school  year  the  Commissioner  of  Health 
shall  after  two  weeks'  written  notice  to  the  board  of  school 
directors  of  such  district  appoint  a  properly  qualified  medical 
inspector  or  inspectors  for  the  district  for  the  remainder  of  the 
school  year  and  shall  fix  the  compensation  for  the  same  which 
shall  be  paid  by  the  district. 

Sec.  1505.  The  medical  inspectors  shall  at  least  once  each  year 
inspect  and  carefully  test  and  examine  all  pupils  in  the  public 
schools  of  their  districts  giving  special  attention  to  defective 
sight  hearing  or  other  disabilities  and  defects  specified  by  the 
Commissioner  of  Health  in  his  directions  for  the  medical  ex- 
aminations of  schools.  Each  medical  inspector  shall  make  to  the 
teacher  or  if  the  board  of  school  directors  so  directs  to  the  prin- 
cipal or  district  superintendent  of  schools  a  written  report  con- 


47 

cerning  all  pupils  found  to  need  medical  or  surgical  attention 
and  giving  careful  directions  concerning  the  care  of  each  pupil 
who  needs  special  care  while  in  school.  The  teacher  or  the  prin- 
cipal or  district  superintendent  shall  keep  such  report  until  the 
end  of  the  school  year  shall  carry  out  as  carefully  as  possible  said 
directions  concerning  the  special  care  of  pupils  while  in  school 
and  shall  promptly  send  a  copy  of  the  medical  inspector's  report 
upon  each  child  to  the  parents  or  guardian  thereof. 

Sec.  1506.  The  medical  inspector  shall  at  least  once  each  year 
and  as  early  in  the  school  term  as  possible  make  a  careful  examina- 
tion of  all  privies  water  closets  urinals  cellars  the  water  supply 
and  drinking  vessels  and  utensils  and  shall  make  such  additional 
examinations  of  the  sanitary  conditions  of  the  school  buildings 
and  grounds  as  he  deems  necessary  or  as  the  regulations  of  the 
State  Department  of  Health  or  the  rules  of  the  board  of  school 
directors  or  of  the  local  board  of  health  require.  He  shall  see 
that  the  laws  of  the  Commonwealth  relating  to  the  health  and 
sanitation  of  the  public  schools  and  the  requirements  of  the  local 
board  of  health  are  complied  with. 

Sec.  1507.  He  shall  promptly  make  such  reports  to  the  Com- 
missioner of  Health  as  are  required  by  him  or  by  the  regulations 
of  his  department  and  such  reports  to  the  local  boards  of  school 
directors  as  he  deems  necessary  or  as  are  required  by  the  Com- 
missioner of  Health  or  by  the  board  of  school  directors.  He 
shall  perform  such  other  duties  as  may  be  required  by  the  health 
and  sanitation  laws  of  this  Commonwealth  or  by  the  board  of 
school  directors. 

Sec.  1508.  Any  board  of  school  directors  may  employ  one  or 
more  school  nurses  who  shall  be  graduates  of  reputable  training 
schools  for  nurses  and  shall  define  their  duties. 

Sec.  1509.  No  person  having  tuberculosis  of  the  lungs  shall  be 
a  pupil  teacher  janitor  or  other  employee  in  any  public  school 
unless  it  be  a  special  school  carried  on  under  the  regulations 
made  for  such  schools  by  the  Commissioner  of  Health. 

Sec.  1510.  Any  pupil  prevented  from  attending  school  on 
account  of  the  health  or  sanitation  laws  of  this  Commonwealth 
or  by  the  sanitary  regulations  of  the  local  board  of  health  or  the 
board  of  school  directors  is  hereby  relieved  from  complying  with 
the  provisions  of  this  Act  concerning  compulsory  attenthuicc 
during  such  time  as  he  is  thereby  prevented  from  attending  school. 


48 


Utah 

CiiAPTiiR  140. — An  Act  Requiring  the  Examination  of  All 

School  Children  to  Ascertain  if  They  have  Defective 

Sic.HT  OR  Hearing,  or  Diseased  Teeth,  or  if  They 

ARE  Addicted  to  Mouth  Breathing 

[Approved  March  20.  191 1] 

Be  it  evaded  by  the  Legislature  of  the  State  of  Utah: 

Section  i.  It  shall  be  the  duty  of  every  teacher  engaged  in 
teaching  in  the  public  schools  of  the  State,  separately  and  care- 
fully, to  test  and  examine  every  child  under  his  jurisdiction  to 
ascertain  if  such  child  is  suffering  from  defective  sight  or  hearing, 
or  diseased  teeth,  or  breathes  through  its  mouth.  If  such  test 
determines  that  any  child  has  such  defect  it  shall  be  the  duty 
of  the  teacher  to  notify,  in  writing,  the  parent  of  the  child  of 
such  defect  and  explain  to  such  parent  the  necessity  of  medical 
attendance  for  such  child. 

Sec  2.  The  State  Board  of  Health  shall  prescribe  rules  for 
making  such  tests,  and  shall  furnish  to  Boards  of  Education 
and  Boards  of  Trustees  of  school  districts,  rules  of  instruction, 
test  cards,  blanks  and  other  useful  appliances  for  carrying  out 
the  purposes  of  this  Act. 

Sec  3.  During  the  first  month  of  each  school  year,  after  the 
opening  of  school,  teachers  must  make  the  tests  required  by 
this  Act  upon  the  children  then  in  attendance  at  school;  and 
thereafter,  as  children  enter  school  during  the  year,  such  tests 
must  be  made  immediately  upon  their  entrance. 

Sec  4.  It  shall  be  the  duty  of  the  Boards  of  Education  and 
Boards  of  Trustees  of  the  several  school  districts  of  the  State  to 
enforce  the  provisions  of  this  Act. 

Sec  5.  The  Board  of  Education  or  Board  of  Trustees  of  any 
school  district  may  employ  regularl}^  licensed  physicians  to  make 
the  tests  required  by  Section  i  of  this  Act,  and  when  such  tests 
are  made  by  a  physician,  the  teachers  shall  not  be  required  to 
make  the  tests  provided  for  in  Section  i  of  this  Act. 


49 

Vermont 

[Approved  November  ii,  1910] 

Number  73. — An  Act  to  Provide  for  the  Medical  Inspec- 
tion OF  Public  and  Private  Schools 

It  is  hereby  enacted  by  the  General  Assembly  of  the  State  of  Vermont: 

Section  i  .  The  school  directors  of  any  town  or  city,  or  the 
school  committee  of  any  incorporated  district,  may  appoint  one 
or  more  medical  inspectors  for  their  schools,  provided  the  legal 
voters  of  such  town,  city,  or  incorporated  district  at  their  annual 
school  meeting  by  vote  instruct  said  directors  or  committee  so 
to  do.  The  compensation  of  such  inspectors  shall  be  fixed  by 
the  school  directors  or  prudential  committee. 

Sec.  2.  Such  medical  inspectors  shall  examine  the  pupils  of 
said  schools,  and  in  all  things  comply  with  such  rules  and  regula- 
tions as  may  be  promulgated  by  the  state  board  of  health  relating 
thereto. 

Sec.  3.  Said  inspectors  shall,  under  the  same  regulations, 
examine  the  pupils  of  any  private  school  when  requested  so  to 
do  by  the  principal  thereof,  or  whenever  any  communicable 
disease  is  present  in  any  town  or  city  in  which  such  private 
school  may  be  located,  or  when  the  pupils  thereof  may  have  been 
exposed  to  any  communicable  disease. 

Sec.  4.  This  act  shall  take  effect  September  i,  191 1. 


Virginia 

[Enacted  1910] 

"The  school  boards  of  the  cities  and  counties  may,  in  their 
discretion,  select  and  appoint  medical  inspectors  of  school 
children  whose  duties  and  compensation  shall  be  prescribed  by 
the  respective  boards,  and  who  shall  report  to  and  be  under  the 
control  of  said  boards." 


I 


50 


Washington 

Code  of  Public  Instruction.    Chapter  97,  Session  Laws  of 
1909. — Paragraph  191,  Applying  to  Districts  of  the 
First  Class 

Fourteenth.  To  appoint  a  practising  physician,  resident  of 
the  school  district,  who  shall  be  known  as  the  School  District 
Medical  Inspector,  and  whose  duty  it  shall  be  to  decide  for  the 
board  of  directors  all  questions  of  sanitation  and  health  affecting 
the  safety  and  welfare  of  the  public  schools  of  the  district;  he 
or  authorized  deputies  shall  make  monthly  inspections  of  each 
school  in  the  district  and  report  the  condition  of  the  same  to  the 
Board  of  Education  and  Board  of  Health. 


West  Virginia 

[Enacted  February,  191 1] 

An  Act  to  Establish  Medical  Inspection  in  Public  Schools 
Be  it  enacted  by  the  Legislature  of  West  Virginia: 

That  the  board  of  education  of  each  independent  school  district 
in  this  state  shall  and  other  boards  of  education  may  within 
ninety  days  from  the  passage  hereof  and  thereafter  on  the  first 
day  of  January  of  each  year,  appoint  one  or  more  legally  qualified 
practising  physicians  in  said  school  district  to  be  known  as  medical 
inspector  of  schools,  fix  their  salaries  and  define  their  duties  as 
hereinafter  provided,  and  furnish  the  necessary  stationery  and 
printing  for  records  and  reports. 

It  shall  be  the  duty  of  the  medical  inspector  of  schools  to 
separately  and  carefully  test  each  pupil  in  his  school  once  during 
each  school  year  to  ascertain  if  the  pupil  is  suffering  from  any 
defect  or  disability  that  would  prevent  the  pupil  receiving  the 
full  benefit  of  the  school  work  or  if  some  modification  of  the  school 
work  should  be  made  that  the  pupil  might  receive  the  best  educa- 
tional results. 

The  medical  inspector  also  shall,  at  the  request  of  the  superin- 
tendent of  the  school,  carefully  examine  any  pupil  for  evidence 


I 


51 

of  infectious  or  contagious  disease  or  any  other  condition  which 
might  prove  harmful  to  other  pupils.  Whenever  any  pupil  shows 
symptoms  of  smallpox,  chickenpox,  measles,  scarlet  fever, 
tuberculosis,  diphtheria,  influenza,  whooping  cough,  tonsilitis, 
mumps,  scabies,  syphilis  and  other  venereal  diseases,  trachoma  or 
any  other  contagious  disease,  the  pupil  must  be  sent  home  and 
the  boards  of  health  and  education  notified  in  writing  by 
the  medical  inspector  of  schools.  Any  pupil  with  any  of  the 
said  diseases  cannot  attend  school. 

The  medical  inspector  of  schools  also  shall  carefully  examine 
each  pupil  who  has  been  absent  from  school  for  five  consecutive 
days  for  contagious  or  infectious  disease,  unless  the  pupil  shall 
present  to  the  superintendent  of  the  school  a  written  or  printed 
statement  in  the  form  hereinafter  given,  showing  that  the  pupil 
and  the  house  from  which  the  pupil  comes  is  free  from  infectious 
or  contagious  disease,  signed  by  the  attending  physician  and 
endorsed  by  the  medical  inspector  of  schools. 

The  medical  inspector  of  schools  also  shall,  when  requested 
by  the  board  of  education,  conduct  investigations,  furnish  in- 
formation and  advice  and  assist  to  formulate  rules  of  procedure 
on  matters  pertaining  to  the  lighting,  heating,  ventilating  and 
sanitation  of  the  school  buildings;  the  hours  of  study,  recesses, 
exercises  and  any  other  matter  pertaining  to  the  health,  vitality 
and  development  of  the  pupils.  And,  if  deemed  necessary,  the 
board  of  education  may  employ  a  teacher  nurse  to  investigate 
the  sanitary  conditions  of  the  pupil  and  home. 

The  medical  inspector  also  shall  keep  an  accurate  and  com- 
plete record  of  each  pupil  tested  and  examined  in  the  fol- 
lowing form: 

Date ,  191-  • 

Pupil Age 

Grade School 

Parent  or  guardian 

Heart 

Lungs 

Eyes 

Ears 

Throat 

Teeth 

Contagious  or  Infectious  Disease 


52 

skin  1  )isoase 

SiHcial  Note 

Kccoiuinendalion 

Signed ,    M.D. 

Medical  Inspector  of School. 

And,  when  any  condition  is  found  which,  in  the  opinion  of  the 
nictlical  inspector  would  prevent  the  pupil  receiving  the  full 
benefit  of  the  school  work  or  would  be  a  symptom  of  infectious 
or  contagious  disease,  the  medical  inspector  shall  notify  the 
parent  or  guardian  and  the  superintendent  of  the  school  at- 
tended, using  the  following  form: 

,191- • 

The  parent  or  guardian  of 

attending School 

is  hereby  notified  that  examination  of  this  pupil  shows  abnormal 
condition  of 

Take  the  pupil  to  your  family  physician  for  treatment  and  advice 
and  take  this  card  with  you. 

,    M.D. 

Medical  Inspector School. 

and  on  the  reverse  side  shall  be  printed 

I  have  this  day  examined 

of  the Grade School 

and  find  the  following  condition 

and  have  advised  as  follows 


Signed ,    M.D. 

Dated Physician. 

The  physician  signing  will  return  card  to  the  pupil  who  will 
return  it  to  the  superintendent  of  the  school  attended. 
And,  when  any  pupil  shall  have  been  absent  from  school  for 


53 

five  consecutive  days,  statement  must  be  made  to  the  superin- 
tendent of  the  school  attended  in  the  following  form: 

Date ,  IQI-  • 

I  have  this  day  examined 

of  the School 

and  find  this  pupil  and  the  house  from  which  the  pupil  comes 
to  be  free  from  infectious  or  contagious  disease. 

Signed ,    M.D. 

Approved : ,  M.D. 

Medical  Inspector School. 


Some  Publications  of  the  Department  of  Child 
Hygiene,  Russell  Sage  Foundation 

400  Metropolitan  Tower,  New  York  City- 


Medical  Inspection 

No.  54.  The  Argument  for  Medical  Inspection  and  Some  Signi- 
ficant Facts 

Hygiene  and  Health 

No.  71.  Open  Air  Schools.     Leonard  P.  Ayres,  Ph.D. 

No.  loi.  What  American  Cities  are  Doing  for  the  Health  of 
School  Children.  (Price  15  cents.)  (A  Report  Sum- 
marizing Conditions  in  1038  cities.) 


Medical  Inspection  of  Schools. — Luther  H.  Gulick,  M.D.,  and  Leonard 
P.  Ayres,  Ph.D.  276  pages.  Price,  postpaid,  $1.00.  Charities  Pub- 
lication Committee,  105  East  22d  Street,  New  York  City. 

Gives  in  convenient  form  information  about  the  historical,  educa- 
tional, administrative,  and  legal  phases  of  the  work.  The  most  extensive 
bibliography  on  the  subject  yet  compiled  is  added.  This  book  has  run 
into  three  editions. 

Open  Air  Schools. — Leonard  P.  Ayres,  Ph.D.  171  pages.  Price  $1.20 
(postage  12  cents).     Doubleday,  Page  &  Co.,  New  York. 

This  volume  gives  the  important  and  significant  American  and 
foreign  material  with  respect  to  outdoor  schools.  It  describes  the  Eng- 
lish, German  and  American  types,  gives  the  results  and  furnishes  de- 
finite information  with  respect  to  clothing,  food,  cost,  administration, 
etc.  It  has  more  than  70  pages  of  illustrations  and  diagrams.  Biblio- 
graphy. 


A  leaflet  giving  full  list  of  printed  matter  will  be  mailed  on  request. 


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